Jaettu päätöksenteko neurologian arjen kliinisessä työssä: Alustavia tuloksia potilaiden ja lääkärien kokemuksista

Shared decision-making (SDM) is an important element of patient participation in healthcare, which is generally favoured by the patients. This pilot study examined neurologists’ and patients’ perspectives on SDM, focusing on epilepsy and multiple sclerosis care in Finland. Neurologists and patients completed e-surveys including validated SDM instruments. Neurologists were recruited through the Finnish Neurological Society and patients through the Finnish Neuro Society and the Finnish Epilepsy Association. Among 30 hospital neurologists, most viewed treatment decisions as ideally made collaboratively with the patient. They also reported SDM as a typical, though variably applied, practice. SDM tended to materialize particularly in the planning of follow-up care. In contrast, patients were less often explicitly told that their participation is valued in the decision-making. In the patient sample (N = 100), SDM was also viewed as a common practice. Patients reported lower levels of SDM than neurologists. Sufficient consultation time emerged as a key structural factor enabling SDM. SDM is embedded in neurological care practices. However, patients could be involved more actively when choosing between treatment options. SDM appears to be more strongly recognized by neurologists than experienced by patients, indicating an implementation gap as well as differences in how SDM practices are understood. Strengthening structural conditions, such as time allocation and clearer communicative practices, may support both implementation and recognition of SDM.