Whitney C Sewell1, Patricia Solleveld2, Dominika Seidman3,4, Christine Dehlendorf5, Julia L Marcus1, Douglas S Krakower6,7. 1. Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Ste 401, Boston, MA, 02215, USA. 2. Beth Israel Deaconess Medical Center, Division of Infectious Diseases, 110 Francis St., W/LMOB Suite GB, Boston, MA, 02215, USA. 3. Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. 4. San Francisco General Hospital, 1001 Potrero Ave Ward 6D, San Francisco, CA, 94110, USA. 5. Family and Community Medicine, University of California, San Francisco, San Francisco General Hospital, 995 Potrero Avenue, Ward 83, San Francisco, CA, 94110, USA. 6. Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Ste 401, Boston, MA, 02215, USA. dkrakowe@bidmc.harvard.edu. 7. Beth Israel Deaconess Medical Center, Division of Infectious Diseases, 110 Francis St., W/LMOB Suite GB, Boston, MA, 02215, USA. dkrakowe@bidmc.harvard.edu.
Abstract
PURPOSE OF REVIEW: Shared decision-making is a process that involves bidirectional exchange of information between patients and providers to support patients in making individualized, evidence-based decisions about their healthcare. We review the evidence on patient-led decision-making, a form of shared decision-making that maximizes patient autonomy, as a framework for decisions about HIV preexposure prophylaxis (PrEP). We also assess the likelihood that patient-led decision-making occurs for PrEP and describe interventions to facilitate this process. RECENT FINDINGS: Patient-led decision-making is likely to be uncommon for PrEP, in part because healthcare providers lack knowledge and training about PrEP. Few evidence-based interventions exist to facilitate patient-led decision-making for PrEP. There is a need for rigorously developed interventions to increase knowledge of PrEP among patients and healthcare providers and support patient-led decision-making for PrEP, which will be increasingly important as the range of available PrEP modalities expands.
PURPOSE OF REVIEW: Shared decision-making is a process that involves bidirectional exchange of information between patients and providers to support patients in making individualized, evidence-based decisions about their healthcare. We review the evidence on patient-led decision-making, a form of shared decision-making that maximizes patient autonomy, as a framework for decisions about HIV preexposure prophylaxis (PrEP). We also assess the likelihood that patient-led decision-making occurs for PrEP and describe interventions to facilitate this process. RECENT FINDINGS: Patient-led decision-making is likely to be uncommon for PrEP, in part because healthcare providers lack knowledge and training about PrEP. Few evidence-based interventions exist to facilitate patient-led decision-making for PrEP. There is a need for rigorously developed interventions to increase knowledge of PrEP among patients and healthcare providers and support patient-led decision-making for PrEP, which will be increasingly important as the range of available PrEP modalities expands.
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