OBJECTIVES: The association of shared decision making (SDM) and/or decision aids (DA) with health outcomes has not been well assessed among pain patients. Therefore, this study aimed to estimate the association of SDM/DA with health outcomes among pain patients.

METHODS: Systematic search was conducted using Medline, Embase, CINAHL, Psych INFO, Cochrane library and trial registries (World Health Organization, ClinicalTrials.gov), from inception to June 18, 2020. Inclusion criteria were studies comparing SDM/DA with usual care among pain patients. Outcome measures were decisional conflict scale (DCS), knowledge, and satisfaction with decision (SWD), decision making, and treatment/care. Two investigators independently screened the articles identified for inclusion. Disagreements were resolved with a third reviewer through consensus. Standardized differences in means were used to measure outcomes in the meta-analysis. Heterogeneity was evaluated by Cochran’s Q test and I² statistic.

RESULTS: Of 7806 sources identified in the search, data from 14 studies were pooled for meta-analyses. SDM/DA were associated with a reduction in DCS (standardized difference in means=-0.213; 95% confidence intervals (CI)=-0.345, -0.080; p=0.002; I²=64.571); DCS among patients with chest pain (standardized difference in means=-0.355; 95% CI=-0.589, -0.121; p=0.003; I²=72.664); and increased knowledge (standardized difference in means=0.274; 95% CI=0.121, 0.428; p<0.001 I²=75.843). There was no statistically significant association with: satisfaction with decision making (standardized difference in means=0.131; 95% CI=-0.019, 0.281; p=0.087; I²=49.045); SWD (standardized difference in means=0.161; 95% CI=-0.043, 0.366; p=0.123; I²=14.536); or satisfaction with treatment/care (standardized difference in means=-0.058; 95% CI=-0.340, 0.225; p=0.689; I²=70.756).

CONCLUSIONS: The results of this study suggest that SDM/DAs are associated with statistically significant reduction in decisional conflict and increase in knowledge. Future work should focus on better understanding clinically meaningful change, benefits of SDM among pain patients, and implementation of SDM in the clinical setting.