Please cite this article in press as: Kebbe M, et al. Is there a role for shared decision-making in pediatric weight
management? Obes Res Clin Pract (2018), https://doi.org/10.1016/j.orcp.2018.01.004
ARTICLE IN PRESS
ORCP-710; No. of Pages 3
Obesity Research & Clinical Practice (2018) xxx, xxx—xxx
ORIGINAL ARTICLE
Is there a role for shared decision-making
in pediatric weight management?
Maryam Kebbe
*
, Arnaldo Perez, Geoff D.C. Ball
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta,
11405—87 Avenue, Edmonton, Alberta T6G 1C9, Canada
Received 24 August 2017; accepted 11 January 2018
KEYWORDS
Decision making;
Evidence-based
medicine;
Patient-centered care;
Pediatric obesity
Summary Shared decision-making (SDM) is central to personalising health and
medical decisions. This decisional model encourages patients to act as managers of
their own care while maintaining a partnership with health professionals. Although
applied to some conditions, SDM has been used infrequently in pediatric weight
management (PWM). Herein, we highlight the applicability and usefulness of SDM
in making several important decisions related to PWM, including referral-making to
different levels of care and treatment initiation and implementation. We conclude
by describing possible challenges that may arise when implementing this model and
suggest strategies to optimise the use of SDM in PWM.
© 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd.
All rights reserved.
Shared decision-making (SDM) is a decisional model
in which patients and clinicians share expertise to
identify and make decisions in a collaborative man-
ner [1]. Clinicians share evidence-based, clinical
information about health conditions (e.g., etiol-
ogy, consequences) and treatment options, while
patients assess the risks and benefits of different
*
Corresponding author. Present address: Department of Pedi-
atrics, Faculty of Medicine & Dentistry, University of Alberta,
4-580 Edmonton Clinic Health Academy, 11405—87 Avenue,
Edmonton, Alberta T6G 1C9, Canada.
E-mail addresses: kebbe@ualberta.ca (M. Kebbe),
perezgar@ualberta.ca (A. Perez), gdball@ualberta.ca
(G.D.C. Ball).
therapies based on the information provided and
their own beliefs, preferences, and values. SDM is
useful when a range of therapeutic options exist,
the available evidence does not point to a clearly
superior option, and patients must assess the risks
and benefits of available options [1]. Although
suggested to support decision-making in pediatric
healthcare, to our knowledge, this model has been
used infrequently in pediatric weight management
(PWM) specifically.
Given that most children referred for PWM do not
enroll in care [2], clinicians can use SDM with fami-
lies at the ‘front end’ to discuss excess weight and
potential value of a referral. Consistent with expert
https://doi.org/10.1016/j.orcp.2018.01.004
1871-403X/© 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.