Using Shared Decision-Making Resources in Long-Term Care: a Qualitative Study


  • Wade Thompson University of British Columbia; University of Southern Denmark
  • Lisa M. McCarthy Institute for Better Health, Trillium Health Partners; University of Toronto; Bruyère Research Institute; Women’s College Research Institute; University of Waterloo
  • Emily Galley Bruyère Research Institute; University of Calgary
  • Loreena Homan Bruyère Research Institute
  • Barbara Farrell Bruyère Research Institute; University of Waterloo; University of Ottawa



shared decision-making, deprescribing, older adults, medication management, resource implementation



Shared decision-making (SDM) incorporates people’s individual preferences and context into individualized, person-centred decisions. Persons living in long-term care (LTC) should only take medications that are a good fit for them as individuals.


We conducted a pilot study to understand experiences of two LTC homes in Ontario as they tested implementing SDM resources to support medication decisions. LTC homes conducted two Plan-Do-Study-Act (PDSA) cycles supported by an Advisory Group composed of LTC home representatives and stakeholders involved in resource design. Rapid quali-tative analysis of transcripts and field notes from Advisory Group meetings elucidated how SDM resources were used.


Each site was positively engaged but implemented resources differently. The pharmacist and physicians at Site 1 introduced proton-pump inhibitor (PPI) deprescribing as their primary intervention, identifying suitable residents, informing residents and families of the deprescribing process, and providing selected SDM resources to residents, caregivers and staff. Representatives reported limited engagement with SDM resources and difficulty measuring the impact of PPI deprescribing. Representatives from Site 2 disseminated the SDM resources to residents and caregivers for use at care conferences and focused on front-line staff education and involvement. This site reported that some residents/caregivers were interested in participating in SDM and using the resources, while others were not. The impact of the resources on SDM at this site was unclear.


Within the context of LTC, further research is needed to clarify the meaning and importance of SDM in medication decision-making. Implementation of SDM will likely require a multi-faceted approach.


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How to Cite

Thompson W, McCarthy LM, Galley E, Homan L, Farrell B. Using Shared Decision-Making Resources in Long-Term Care: a Qualitative Study. Can Geriatr J [Internet]. 2023 Jun. 1 [cited 2023 Nov. 30];26(2):253-8. Available from:



Original Research