Patient Decisional Preferences: A Systematic Review of Instruments Used to Determine Patients' Preferred Role in Decision-Making.

Abstract

Decision control preferences (DCPs) refer to the degree of control patients' desire over their medical treatment. Several validated tools exist to evaluate a patient's DCPs, yet there is no universally used instrument and their use in clinical settings is lacking. We provide a systematic comparative summary of available DCP tools. Following a systematic database search, English language studies across medical contexts and patient populations were eligible if a validated assessment tool to evaluate patient DCPs was reported. Among the 15 tools that met inclusion criteria, the autonomy preference index (API) and the control preference scale (CPS) were the most used tools (API: 40%, CPS: 26.6%). Most studies (n = 9) sought to identify the information-seeking preferences of patients as a critical component of decision-making. Only few studies evaluated providers' perceptions of patient preferences. Considering the variety of patients' DCPs, implementation of DCP tools can optimize shared decision-making and improve patient outcomes.