Barriers and facilitators of shared decision-making in prostate cancer screening in primary care: A systematic review

María Estevan-Vilar; Lucy Anne Parker; Juan Pablo Caballero-Romeu; Elena Ronda; Ildefonso Hernández-Aguado; Blanca Lumbreras

doi:10.1016/j.pmedr.2023.102539

Barriers and facilitators of shared decision-making in prostate cancer screening in primary care: A systematic review

Prev Med Rep. 2023 Dec 12:37:102539. doi: 10.1016/j.pmedr.2023.102539. eCollection 2024 Jan.

Authors

María Estevan-Vilar¹, Lucy Anne Parker^{2

3}, Juan Pablo Caballero-Romeu^{4

5}, Elena Ronda^{3

6}, Ildefonso Hernández-Aguado^{2

3}, Blanca Lumbreras^{2

3}

Affiliations

¹ Pharmacy Faculty, Miguel Hernandez University, 03550 San Juan de Alicante, Spain.
² Department of Public Health, History of Science and Gynecology, Miguel Hernandez University, 03550 San Juan de Alicante, Spain.
³ CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain.
⁴ Department of Urology, Hospital General Universitario de Alicante, 03010 Alicante, Spain.
⁵ Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain.
⁶ Public Health Research Group, Alicante University, 03690 San Vicente del Raspeig, Spain.

Abstract

Objective: To identify barriers and facilitators of the implementation of shared decision-making (SDM) on PSA testing in primary care.

Design: Systematic review of articles.

Data sources: PubMed, Scopus, Embase and Web of Science.

Eligibility criteria: Original studies published in English or Spanish that assessed the barriers to and facilitators of SDM before PSA testing in primary care were included. No time restrictions were applied.

Data extraction and synthesis: Two review authors screened the titles, abstracts and full texts for inclusion, and assessed the quality of the included studies. A thematic synthesis of the results were performed and developed a framework. Quality assessment of the studies was based on three checklists: STROBE for quantitative cross-sectional studies, GUIDED for intervention studies and SRQR for qualitative studies.

Results: The search returned 431 articles, of which we included 13: five cross-sectional studies, two intervention studies, five qualitative studies and one mixed methods study. The identified barriers included lack of time (healthcare professionals), lack of knowledge (healthcare professionals and patients), and preestablished beliefs (patients). The identified facilitators included decision-making training for professionals, education for patients and healthcare professionals, and dissemination of information.

Conclusions: SDM implementation in primary care seems to be a recent field. Many of the barriers identified are modifiable, and the facilitators can be leveraged to strengthen the implementation of SDM.

Keywords: Barriers and facilitators; Primary care; Prostate cancer; Prostate-specific antigen (PSA); Screening; Shared decision-making.

Publication types

Review