合理用药视角下医患共同决策应用场景、应用模型及辅助工具研究

    Research on Clinical Contexts, Models and Decision Aids in Shared Decision-making Guided by Rational Use of Medicines

    • 摘要:
      目的  分析中国医患共同决策(shared decision-making,SDM)临床场景、模型及辅助工具的应用现状及发展趋势,基于用药决策与合理用药,为优化实践路径提供参考。
      方法 采用范围综述方法,系统检索中国知网、中国生物医学文献数据库等数据库,依据标准筛选文献并提取资料,从研究特征、应用场景、应用模型及工具等维度进行描述性分析,重点关注SDM在用药决策中的作用。
      结果 初检得1606篇文献,最终纳入159篇。研究发现国内医患共同决策研究呈现增长趋势,临床应用集中于慢性病与肿瘤,尤其在糖尿病、精神疾病等领域,医患共同决策模型涵盖理论与实践,在辅助工具、参与主体等延伸主题考量深入。
      结论 国内医患共同决策从基础理论走向临床实践,未来应考虑到主体视角与场景差异,拓展医患共同决策应用至治疗药物决策与合理用药等延伸主题,注重多样化工具与多学科主体参与,同时健全支持体系,完善政策法规,推动患者偏好融入临床合理用药实践,为中国医患共同决策研究做出贡献。

       

      Abstract:
      OBJECTIVE  To analyze the current status and development trends of clinical contexts, models and decision aids in shared decision-making(SDM) in clinical practice in China, and to provide evidence for optimizing practical pathways based on medication decision-making and rational medication use.
      METHODS  A scoping review was conducted by systematically searching databases including China National Knowledge Infrastructure(CNKI), SinoMed, stc., and applying standardized criteria for literature screening and data extraction. Descriptive analysis focused on research characteristics, application scenarios, and tool utilization, with an emphasis on the role of SDM in medication decision-making.
      RESULTS  The initial examination yielded 1606 documents, and 159 were finally included. The study revealed a growing trend in SDM research in China, with clinical applications concentrated in chronic diseases(e.g., diabetes) and oncology. SDM models integrated theory and practice, with in-depth exploration of decision aids and participant roles. Notably, SDM demonstrated significant potential in improving medication adherence and rational drug use, particularly in diabetes and psychiatric care.
      CONCLUSION  SDM in China is transitioning from theoretical exploration to clinical implementation. Future efforts should address diverse perspectives and clinical scenarios, extend SDM to medication decision-making and rational use, prioritize multidisciplinary collaboration and innovative tools, and strengthen policy frameworks to integrate patient preferences into clinical practice. This will contribute to advancing SDM research and enhancing therapeutic outcomes in China.

       

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