Exploring perceptions and predictors of shared decision-making in the pharmacological management of Parkinson’s disease: insights from patients and healthcare providers

Parkinson’s disease requires complex pharmacological choices, yet patients often feel insufficiently involved in decisions. Understanding how patients and healthcare providers perceive shared decision-making, and what predicts perceived shared decision-making, can guide improvement. To compare patient and provider perceptions of shared decision-making in pharmacological management of Parkinson’s disease, and to examine whether sociodemographic variables and patient health literacy predict perceived shared decision-making. A cross-sectional online survey included 210 patients with Parkinson’s disease and 80 prescribing healthcare providers in the USA. Shared decision-making was measured with the nine-item Shared Decision-Making Questionnaire for patients and the physician version for providers. Patient health literacy was measured with the Health Literacy Instrument for Adults (range 0–132). Analyses included descriptive statistics, independent group comparisons, analysis of variance, simple linear regression, and multiple linear regression. Patients reported a mean shared decision-making score of 29.56 (standard deviation 10.39), and providers reported 37.83 (standard deviation 6.47). Providers rated perceived shared decision-making significantly higher than patients at the group level. Among patients, analysis of variance showed no differences by age, education, ethnicity, employment, region type, or region of residence; marital status was associated with higher scores for married, divorced, and widowed individuals compared with single, never married individuals. Health literacy predicted patient-reported shared decision-making in simple models but was not significant when sociodemographic variables were included. In multiple regression, graduate education, being married, divorced, or widowed, and rural residence predicted perceived shared decision-making. Provider ethnicity and region of residence predicted provider-reported shared decision-making. Differences in general perceptions of shared decision-making exist between patients and providers. Enhancing communication, using decision aids, and intentionally engaging care partners may strengthen shared decision-making in the pharmacological management of Parkinson’s disease.