Can shared decision-making interventions increase trust/trustworthiness in the physician-patient encounter? A scoping review.

Abstract

To summarize the existing literature on the impact of shared decision-making (SDM) interventions on patient trust, with a focus on the specific characteristics that influence the effectiveness of each intervention regarding the outcome of trust. We conducted a systematic search of the literature with the aid of a research librarian. Data was extracted via Covidence regarding the characteristics of the study including interventions performed, trust scale used, primary and secondary outcomes, and effect size. From 6090 articles, 97 met criteria for full text review and 20 met inclusion criteria. Sixteen of these were original studies while the remaining 4 were secondary analyses. Eight studies reported a statistically significant increase in trust within the intervention group compared to controls while 12 reported no statistically significant changes. None had trust as a primary outcome. Interventions aimed at increasing SDM have the ability to increase trust, but do not always succeed at doing so. The results indicate that increasing SDM can improve trust in the physician-patient relationship, especially when SDM results in improved communication from clinicians. Further studies should look at populations with low baseline trust since a ceiling effect can occur with trust scales.