139 Pharmacists’ involvement in shared decision making: a scoping review
Bibliographic record
Abstract
<h3>Introduction</h3> Pharmacy practice has evolved considerably in many healthcare systems, moving towards more direct involvement in patient care. Shared decision-making (SDM) is an essential part of high-quality, patient- centered care. This study aimed to assess the manner and the extent to which pharmacists are involved in SDM, and the barriers and facilitators to their involvement. <h3>Methods</h3> We conducted a scoping review using the methodology from the Joanna Briggs Institute and included any type of document about SDM in pharmacy or involving pharmacists, provided that SDM was explicitly mentioned. Searches were carried out on MEDLINE, Embase, Cochrane RCT and Systematic Review. Pairs of reviewers independently screened documents and extracted data. A descriptive analysis of study characteristics and a thematic analysis of content relevant to the objectives was performed. <h3>Results</h3> A total of 302 references was evaluated for eligibility, with 28 full-length papers reporting on 24 studies included for analysis. SDM was infrequently performed with patients and with other healthcare professionals as part of multidisciplinary teams. Pharmacist-led SDM interventions described in the literature consisted mostly of medication reviews with the goal of deprescribing in older patients, and discussion of treatment options or management issues with patients initiating chemotherapy, at risk or living with diabetes, and taking antidepressants. Barriers and facilitators concerned pharmacists’ attitudes towards SDM, interprofessional collaboration, relationships with patients, skills and resources. <h3>Discussion</h3> While infrequent, pharmacist participation in SDM is possible and beneficial, specifically where complex medication decisions need to be made while considering patients‘ goals, such as the treatment of chronic conditions or the reduction of potentially inappropriate prescribing. To facilitate their full participation, many challenges must be addressed. <h3>Conclusion</h3> This review did not find evidence that pharmacists widely practiced SDM, but suggested some avenues for their involvement, consistent with the expanding scope of pharmacy practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".