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Shared Decision-Making in Conventional Medicine vs. Manual Therapies: A Systematic Review

par Etenaille, Maxime ;De Luca, Valentin;Foucart, Jennifer
Référence Optimizing communication in healthcare: a belgian symposium (28/11/2025: Brussels)
Publication Non publié, 2025-11-28

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Résumé :

Background:Shared decision-making (SDM) plays a critical role in promoting patient engagement and improving therapeutic outcomes. Despite its recognized value, the degree of SDM implementation may vary between healthcare fields, particularly between conventional medicine and manual therapies.Objective:To compare the integration of SDM in conventional medicine and manual therapies by examining practices, perceived barriers, and facilitating factors.Methods:A systematic review was conducted using PubMed, PsycINFO, Cochrane Library, and Google Scholar. Ten studies published between 2014 and 2024 were included. The quality of the studies was assessed using adapted CASP checklists for cross-sectional, randomized, and qualitative studies. SDM levels were measured using validated tools (OPTION-12, SDM-Q-9, SDM-Q-Doc, etc.), allowing for cross-comparison between the two healthcare domains.Results:Self-reported SDM scores from both patients and practitioners were generally high; however, external assessments indicated lower actual implementation, particularly in conventional medicine. Manual therapies demonstrated slightly higher SDM engagement. Main barriers included a lack of specific SDM training and limited consultation time in conventional settings, while manual therapies faced the challenge of having few adapted tools. Key facilitators identified were professional training, the use of decision aids, and institutional support for SDM practices.Conclusion:While manual therapies show a marginally higher integration of SDM, its overall use remains limited across both fields. Improving clinician education, developing tailored communication tools, and embedding supportive organizational frameworks are essential to foster effective patient participation in decision-making.