Shared decision making is a key component to the patient-centered medical home, yet little research has been done to explore shared decision making—and the barriers to it—in HIV management and care.
“It is important to understand that for any one patient, his or her interest in developing collaborative care plans can change over time and may vary for different health conditions,” said Shannon Fuller, MS, a research analyst at the University of California, San Francisco Center for AIDS Prevention Studies and lead author of a new report on shared decision-making in HIV/AIDS patients.
The study reveals that while there are many opportunities for shared decision making due to the technical advances in HIV care, few participants reported feeling as if they had a role in deciding their care.
“In our study, we spoke with a number of patients who had been living with HIV for more than a decade. According to their own reports, their HIV was well-managed and they expressed greater concern for other co-morbidities such as diabetes and neuropathy,” Fuller told Medical Economics. “It may sound strange, but many patients in our study did not feel that there were a lot of choices that could be made in terms of HIV care.”
The biggest choices that patients endorsed, she said, was whether or not to take antiretroviral treatment, and then which medications to take. Patients didn’t feel, however, that they knew enough about the medication options to make this decision well, choosing often to defer this decision to their medical provider, according to the study.