Authors' objectives: We want to find out how we can improve the way we involve older people, and their family carers, in decisions about their health and social care. We call this approach shared decision making (SDM). In particular we want to find out how SDM can work in community settings where many different health and social care workers (such as GPs, nurses, social carers) may be involved in caring for the older person. Background Sharing decisions and information with patients are key goals of integrated care. It is hoped that SDM will help patients feel more confident in managing their own care. SDM may also need to include family carers; especially for older people with more than one health problem, or who have conditions such as dementia. However, we currently don t know the best way to make sure that older people, and their carers, are included in decision making about their healthcare. In addition, we need to know more about how SDM can work when decisions need to be discussed and shared with a number of different health and social care practitioners, as well as with patients and their family carers. Design and methods For this review we plan to use a research approach called realist synthesis. In realist synthesis the views of stakeholders (for example patients, carers, practitioners and policy makers) are very important in helping to guide the review process. There are three phases to the review. In Phase 1 we want to find out what approaches are used to involve older people, and their carers, in SDM. We also want to explore how these different approaches to SDM are thought to work. To do this we will: - Undertake an initial review of relevant literature - Consult with a range of expert groups, including patients, family carers, and practitioners who work in sites providing integrated care - Hold a workshop to discuss the findings and agree a set of statements about what is thought to be necessary for SDM to work. In Phase 2 we will: - Undertake a second more detailed search of the literature to see if the statements developed in Phase 1 are supported by the evidence - Explore what the literature tells us about the different elements of SDM and how it is linked to particular situations and outcomes. - Hold a second workshop to: a) discuss the findings, b) identify common themes in the evidence and c) refine the statements developed in Phase 1 about how SDM can work. In particular how it might affect outcomes such as patient satisfaction and quality of health and social care. In Phase 3 we will: - Go back to the experts we spoke to in Phase 1 to a) see if they think the findings make sense to them, and b) discuss what would be necessary to implement them in practice. - Work with our Advisory Group and other experts to produce recommendations. These recommendations will be designed to a) help people delivering and planning care, and b) inform the development of future research studies. Patient and public involvement We will work with two well-established patient and public involvement groups. Members of these groups will be invited to join the Advisory Group, attend project workshops, comment on study outputs and be involved in disseminating the findings. Dissemination Outputs will include a final report and linked journal publications. We will use our practice, clinical, service provider and patient involvement networks to disseminate the findngs.

Project Status: Completed

URL for project: http://www.nets.nihr.ac.uk/projects/hsdr/157725

Year Published: 2018

URL for published report: https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/157725/#/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Services and Delivery Research programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: Queen's Printer and Controller of HMSO