Unlocking Shared Decision-Making in Anaesthesia: A Roadmap for Patient-Centered Pain Care
A systematic review in Anaesthesia identifies nine key activation targets to move shared decision-making from tokenistic endorsement to routine clinical practice in peri-operative anaesthesia. The mixed-methods study, synthesizing qualitative and quantitative data, maps barriers and facilitators to the Theoretical Domains Framework. It highlights clinician-level priorities like structured communication training and direct preference elicitation, patient-level needs such as anxiety-reducing explanations, and system-level changes including earlier consultation scheduling and protected time for discussions. The findings offer a practical, theoretically-informed strategy to enhance multimodal analgesia planning and improve patient-centered outcomes in acute and peri-operative pain management.
Study Significance: For pain medicine specialists, this research provides a concrete framework to improve the consent and planning process for interventional pain procedures and complex analgesic regimens. Implementing these activation targets can enhance patient engagement, reduce decisional conflict, and support opioid stewardship conversations by ensuring choices about nerve blocks, spinal cord stimulation, or pharmacotherapy are explicitly collaborative. This shifts practice towards a more integrated, behavioral pain therapy approach within procedural workflows.
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