Shared decision-making (SDM) is central component of patient-centered care and is of
particular interest in contraceptive counselling, where a range of potentially suitable options are
available, and personal preferences and values must guide clinical decisions. A systematic search
was conducted in MEDLINE (via Ovid) and CINAHL to identify qualitative, quantitative, and
mixed-methods studies published between 2019 and 2024. Inclusion criteria focused on studies
evaluating SDM tools or strategies in clinic-based settings with women of reproductive age.
Among the seven articles included in this review, a variety of SDM tools and strategies were
used: decision aids, interview guides, provider prompts, and physical models. Key outcomes
included improved patient satisfaction, decisional certainty, interpersonal quality of
contraceptive counselling, perceived self-efficacy in decision-making and increased
contraceptive knowledge. However, there was variability in how SDM was measured and
whether outcomes were explicitly linked to SDM processes. Findings suggest that effective
implementation of SDM tools or strategies in primary care practice may require a multifaceted
approach involving both pre-visit patient tools and provider and patient supports during
contraceptive counselling. Future research should seek to more clearly establish causal links
between SDM strategies and outcomes, and to evaluate SDM tools or strategies in the Canadian
context.
