Shared Decision-Making in Lifestyle Medicine in Viet Nam: Health Literacy, Treatment Trade-Offs, and Patient Choice

Shared Decision-Making in Lifestyle Medicine in Viet Nam: Health Literacy, Treatment Trade-Offs, and Patient Choice

Primary category: Evidence & Clinical Practice

Secondary category: Lifestyle Medicine in Viet Nam

Article type: VLMA Perspective

Last reviewed: October 29, 2026

Two patients with the same medical condition may receive similar lifestyle recommendations but face very different choices about how to follow them.

One may have a predictable working schedule, access to suitable food, and family support. Another may work irregular hours, live with several chronic conditions, or find it difficult to attend additional appointments. Both may understand the potential benefits of healthier behaviors, yet the changes they can realistically make may differ considerably.

For healthcare professionals, the challenge is not simply to explain what the evidence recommends. It is to help patients understand their options and participate in decisions that are clinically appropriate, meaningful to them, and realistic in their circumstances.

This is where shared decision-making becomes important.

Lifestyle Medicine uses evidence-based approaches involving nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections to support the prevention and treatment of chronic disease. However, knowing that an intervention can be beneficial does not necessarily determine how it should be applied to every patient.

Different approaches may involve different benefits, risks, costs, and practical demands. Some decisions also require consideration of how lifestyle interventions can be combined with medications or other established treatments.

Shared decision-making brings clinical evidence and professional judgment together with the patient's priorities, preferences, and circumstances. Its purpose is not simply to obtain agreement with a recommendation, but to support an informed decision that the patient understands and has a meaningful opportunity to influence.

For the Vietnam Lifestyle Medicine Alliance (VLMA), this is an important part of connecting evidence-based Lifestyle Medicine with responsible healthcare practice.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. Our work focuses on professional education, knowledge exchange, and supporting the responsible application of Lifestyle Medicine in Viet Nam.

This article examines shared decision-making through the perspectives of health literacy, treatment trade-offs, patient choice, and professional responsibility. It also considers relevant international guidance and the legal framework governing patient rights in Viet Nam.

Shared Decision-Making Is More Than Asking for Agreement

Healthcare professionals routinely explain diagnoses, recommend treatments, and provide advice about healthy behaviors. These discussions are essential, but they do not necessarily mean that patients have participated in making decisions about their care.

A clinician may explain the benefits of physical activity and ask whether a patient agrees to exercise more. The patient may say yes without discussing whether the recommendation is safe, feasible, or compatible with daily responsibilities. The conversation may appear successful even though the patient has not meaningfully participated in choosing an approach.

Shared decision-making goes further. It involves identifying the decision to be made, discussing clinically appropriate options, explaining their potential benefits and limitations, and understanding what matters to the patient before agreeing on a plan.

The United Kingdom's National Institute for Health and Care Excellence describes shared decision-making as a collaborative process in which healthcare professionals and people receiving care work together to make decisions about treatment and care.

Its guideline, Shared Decision Making (NG197), published in June 2021, addresses communication, patient participation, decision-support tools, and the organizational conditions needed to make this approach part of routine healthcare.

An important principle is that patients should be able to participate to the extent they wish.

Some people want detailed information and an active role in comparing alternatives. Others prefer their healthcare professional to provide a clear recommendation after understanding their needs and circumstances. These preferences may change depending on the decision, the patient's condition, and the available options.

Respecting autonomy does not mean requiring patients to make complicated medical decisions without professional guidance.

Healthcare professionals remain responsible for clinical assessment, interpreting the evidence, identifying safety concerns, and recommending options consistent with professional standards. Patients contribute knowledge about their lives, goals, concerns, resources, and preferences.

These contributions are different, but both matter.

Shared decision-making is particularly relevant when more than one clinically reasonable approach exists or when patients may value the benefits and burdens of available options differently.

It remains important when a particular treatment is strongly indicated. In those circumstances, the clinician should explain the recommendation, its rationale, and the potential consequences of accepting or declining it without suggesting that all alternatives are equally safe or effective.

The objective is informed participation, not simply the appearance of agreement.

Understanding Treatment Trade-Offs in Lifestyle Medicine

A treatment may offer important health benefits while also creating demands that deserve consideration.

In clinical practice, these trade-offs are often discussed in relation to medications, diagnostic tests, and procedures. They can be equally relevant to lifestyle interventions.

A structured exercise program may require transportation, professional supervision, and time away from work. A dietary intervention may involve additional planning, changes in household food preparation, or financial considerations. A behavioral intervention may require repeated consultations, self-monitoring, or participation in group activities.

These demands can affect whether a patient is able to begin and continue an otherwise appropriate intervention.

Such difficulties should not automatically be interpreted as a lack of motivation. They are part of the circumstances in which healthcare decisions are made.

Consider an adult with hypertension who would benefit from improving dietary quality, reducing excessive sodium intake, and increasing physical activity.

Several clinically appropriate approaches may be available, depending on the patient's condition, functional capacity, preferences, and resources. The discussion may therefore involve choosing an approach that offers meaningful benefit while remaining feasible over time.

However, shared decision-making should not create a false choice between lifestyle intervention and medication when both are clinically indicated.

Whether medication is required depends on factors such as blood pressure, cardiovascular risk, comorbidities, clinical assessment, and applicable treatment guidance.

A patient's preference for a lifestyle-based approach does not establish that medication can safely be delayed, reduced, or discontinued.

The appropriate discussion may instead concern how recommended medical treatment and realistic lifestyle changes can work together, what monitoring is necessary, and when the plan should be reviewed.

Similar considerations apply to nutrition. Different evidence-based dietary approaches may help address a clinical objective, but they may differ in cost, preparation time, cultural familiarity, nutritional suitability, and acceptability.

A dietary change that is reasonable for one patient may require modification for another with chronic kidney disease, nutritional deficiencies, or other relevant clinical conditions.

Healthcare professionals must explain where meaningful choices exist and where clinical requirements limit those choices.

Patients may place different importance on reducing particular health risks, maintaining independence, limiting treatment burden, or choosing an approach they believe they can sustain. These priorities deserve attention, but they do not make every intervention medically equivalent.

Shared decision-making is therefore not about selecting whichever option is easiest or most appealing. It is about reaching an informed and clinically appropriate decision after considering the evidence and the patient's circumstances.

Health Literacy Makes Participation Possible

Patients cannot meaningfully participate in decisions if they do not understand the information being discussed.

Health literacy is therefore closely connected to shared decision-making.

The World Health Organization describes health literacy as involving the knowledge and competencies people need to access, understand, evaluate, and use health information and services.

This is broader than the ability to read medical instructions or understand a diagnosis.

Patients may need to interpret information about treatment benefits, possible harms, uncertainty, costs, and the consequences of different choices. They may also encounter conflicting claims through healthcare professionals, websites, social media, commercial advertising, and digital platforms.

These sources do not always provide consistent or reliable information.

The World Health Organization's December 2025 publication, Low Health Literacy Is Costing Health, emphasizes that improving health literacy requires more than educating individuals. It also involves strengthening the systems and environments through which people obtain and use health information.

This has direct implications for healthcare organizations.

A patient may struggle to understand a recommendation because the explanation is too technical, the consultation is rushed, or the information assumes knowledge that the patient does not have.

These difficulties should not automatically be treated as deficiencies in the patient.

Healthcare professionals also have a responsibility to communicate clearly.

In Lifestyle Medicine, this may involve explaining why a particular intervention is recommended, what benefits can reasonably be expected, what its limitations are, and how it relates to other aspects of the patient's care.

Plain language is important, but simplifying information should not mean removing significant risks or uncertainties.

A useful conversation may involve presenting information in manageable parts, allowing questions, and inviting patients to explain their understanding in their own words.

The teach-back approach can help identify misunderstandings when used respectfully. Its purpose is to check whether the explanation was clear, not to test or embarrass the patient.

Language and cultural context also matter.

Educational materials developed internationally may require more than literal translation before they are appropriate for Vietnamese patients. The clinical meaning of a recommendation must remain accurate, while the language and examples should be understandable and relevant.

When communication barriers exist, appropriate support should be considered according to the patient's needs and applicable professional requirements.

Health literacy should not be viewed as a fixed characteristic that determines whether someone can participate in decisions. The clarity of the information, the way it is communicated, and the support available can all influence participation.

The objective is not to make patients experts in medical science. It is to provide the information and support needed for informed choices.

Communicating Benefits, Risks, and Uncertainty

The way evidence is communicated can influence how patients understand their options.

Healthcare professionals may be familiar with relative risks, confidence intervals, clinical outcomes, and the strength of scientific evidence. Patients may interpret these concepts differently, particularly when information is presented without sufficient explanation.

A statement such as "this intervention reduces risk" may be accurate but incomplete.

Patients may reasonably want to know how large the expected benefit is, over what period it may occur, how certain the evidence is, and whether the findings apply to someone with their condition.

The National Institute for Health and Care Excellence recommends communicating risks in ways that support understanding. Where suitable data are available, this includes using absolute risks, consistent denominators, and clearly defined time periods.

For example, explaining how many people out of a defined group may experience an outcome can be more informative than reporting only a relative percentage reduction.

Potential benefits and harms should also be presented in a balanced and comparable way.

This is particularly relevant to Lifestyle Medicine because evidence concerning the health benefits of particular behaviors is not necessarily equivalent to evidence supporting every intervention intended to change those behaviors.

Strong evidence that regular physical activity benefits health does not automatically establish that every exercise program or commercial fitness service is effective for a particular clinical condition.

Similarly, evidence supporting a dietary pattern does not establish the effectiveness of every educational program, supplement, or commercial product associated with that pattern.

The nature and strength of the evidence should be explained according to the decision being considered.

When reliable estimates are unavailable, uncertainty should be acknowledged rather than replaced with unsupported numerical claims.

It is also important to avoid presenting lifestyle interventions as automatically risk-free because they do not involve medications or procedures.

Dietary restrictions, physical activity, and other interventions may require clinical adaptation or monitoring in particular populations.

Communicating uncertainty should not be seen as a weakness. It helps patients understand what is known, what remains uncertain, and why a particular recommendation is being made.

The goal is to support informed judgment rather than persuade patients through selective or exaggerated claims.

Patient Decision Aids: What the Evidence Supports

Shared decision-making can take place through a well-conducted clinical conversation. In some situations, structured patient decision aids can provide additional support.

These tools help patients understand the decision being considered, compare available options, examine potential benefits and harms, and reflect on which outcomes matter most to them.

A major Cochrane review published in January 2024 included 209 studies involving 107,698 participants across a wide range of healthcare decisions.

Compared with usual care, patient decision aids improved participants' knowledge, the accuracy of their risk perceptions, and their participation in decision-making. The review also found moderate-certainty evidence that these tools probably help more people make choices consistent with their informed values.

However, the review did not establish that decision aids automatically improve treatment adherence, long-term clinical outcomes, or healthcare costs in every setting.

This distinction matters. A decision aid may improve understanding and the decision-making process without independently demonstrating that the selected intervention will produce a better clinical outcome.

The International Patient Decision Aid Standards Collaboration published an updated framework, International Patient Decision Aid Standards, version 5.0, in The BMJ on June 12, 2026.

The update was developed through an international consensus process involving 202 participants from 26 countries. It identifies criteria for determining whether a resource qualifies as a patient decision aid, essential requirements intended to reduce the risk of biased decisions, and additional criteria that may improve quality.

The framework emphasizes clearly identifying the decision and intended audience, presenting reasonable options and their benefits and harms, helping patients consider what matters to them, using appropriate evidence, and maintaining transparency about information such as funding and publication or update arrangements.

These principles are particularly relevant when educational organizations or commercial businesses develop materials that may influence healthcare choices.

A document designed primarily to encourage patients toward one predetermined product should not be presented as a balanced decision aid simply because it contains medical information.

Decision aids also need to be considered in relation to the population and setting where they will be used.

An internationally developed tool may not reflect the services available, treatment costs, terminology, or clinical pathways in Viet Nam. Any local adaptation should therefore consider the evidence, clinical appropriateness, language, cultural relevance, intended users, and applicable permissions.

The International Patient Decision Aid Standards provide international quality guidance. They are not Vietnamese regulatory approval requirements automatically imposed on every patient leaflet or educational resource.

The Cochrane evidence also covers many kinds of healthcare decisions, rather than specifically establishing the effectiveness of decision aids for every Lifestyle Medicine intervention.

For VLMA, these resources offer useful references for understanding trustworthy decision-support materials. They do not imply that VLMA currently develops, validates, certifies, or clinically implements patient decision aids.

What Recent Research Tells Us About Viet Nam

Health literacy and shared decision-making are receiving increasing research attention in Viet Nam, although the available evidence should be interpreted carefully.

A study published in Patient Education and Counseling in 2026 examined general health literacy, digital health literacy, and online health information-seeking behaviors among 3,550 Vietnamese adults who participated in a nationwide online survey conducted in 2025.

The findings suggested that difficulties with general health literacy could coexist with relatively strong self-reported digital health literacy among respondents.

However, the study's online survey design limits how confidently its findings can be generalized to the entire Vietnamese population, particularly people with limited access to digital technologies.

It is therefore useful for identifying areas of concern, but should not be treated as a definitive national assessment of health literacy across all patient groups.

Another study, published in the Hue Journal of Medicine and Pharmacy in April 2026, examined the Vietnamese version of the nine-item Shared Decision-Making Questionnaire among adults receiving care for chronic conditions at a family medicine facility.

The questionnaire demonstrated acceptable internal consistency, but its confirmatory factor analysis did not achieve conventional standards of model fit.

The findings suggest that the instrument may be useful for further research while also highlighting the need for additional validation in larger and more diverse populations.

It would be premature to conclude that the instrument has been fully validated for routine application across all Vietnamese healthcare settings.

International evidence also suggests that shared decision-making is not consistently achieved in clinical practice.

A systematic review and meta-analysis published in BMJ Evidence-Based Medicine in 2026 examined 174 studies involving nearly 20,000 clinical consultations assessed using the OPTION-12 and OPTION-5 instruments.

The findings suggested that observable patient involvement was often limited and varied considerably across clinical settings and studies.

The very high statistical heterogeneity means that pooled estimates must be interpreted cautiously. The findings cannot be used to describe the quality of shared decision-making throughout Viet Nam.

Taken together, the available research supports a practical conclusion: meaningful shared decision-making requires more than awareness of its principles. It also requires professional communication skills, suitable clinical environments, and appropriate ways to understand whether patients are genuinely involved.

For VLMA, this represents an area where evidence-based professional education and further context-sensitive learning may be valuable.

From Discussion to a Clinically Appropriate Plan

Consider a hypothetical adult receiving ongoing treatment for hypertension and type 2 diabetes.

The patient understands that nutrition, physical activity, and other healthy behaviors can support cardiometabolic health. Their clinician has also recommended continuing appropriate medical treatment and monitoring.

During the consultation, the patient explains that making several major lifestyle changes at once would be difficult because of work commitments and family responsibilities.

A conventional discussion might end with another reminder to eat better, exercise more, and follow the prescribed treatment plan.

A shared decision-making discussion would explore the situation more carefully.

The clinician could explain the clinical priorities, which aspects of treatment are particularly important for safety, and where reasonable choices exist in how lifestyle changes are introduced.

The patient could describe which changes seem achievable, what has been difficult previously, and what support might make participation easier.

Together, they could consider options consistent with the patient's clinical needs and the relevant evidence.

The agreed plan might involve beginning with achievable changes while continuing prescribed treatment and arranging appropriate follow-up.

This would not justify choosing an ineffective intervention simply because it is easier, nor would it permit delaying medically necessary care.

The clinician would remain responsible for explaining significant risks, identifying circumstances requiring reassessment, and ensuring that the agreed approach is clinically appropriate.

The patient would contribute to deciding how suitable interventions can be incorporated into daily life.

The important decision might therefore be less about choosing between medication and lifestyle change and more about determining how recommended treatments can work together.

This example is hypothetical and does not describe an actual VLMA clinical activity or an identifiable patient.

Patient Choice and Professional Responsibility Under Vietnamese Law

Shared decision-making is consistent with important principles of patient rights, but its application must remain within relevant law and professional standards.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15 provides a legal foundation for informed participation in healthcare decisions.

Article 9 addresses patients' rights to receive information and explanations about their health condition, examination and treatment methods, healthcare services, and related costs. It also recognizes the right to receive safe and appropriate care according to the patient's condition and the healthcare facility's circumstances.

Article 10 addresses respect for dignity, protection of private information, and protection against discrimination, mistreatment, and coercion, subject to the circumstances specified by law.

Article 11 provides for patients' rights to choose examination and treatment methods after receiving appropriate information, explanation, and counseling about their condition, potential results, and risks. The right is subject to the exception concerning requests for methods inconsistent with professional and technical requirements, as specified in Clause 4 of Article 40.

Article 13 addresses patients' rights to refuse examination or treatment and to leave a healthcare facility contrary to medical advice. The law establishes requirements concerning professional counseling and written acknowledgment of responsibility for refusal, as well as written acknowledgment when leaving contrary to medical advice, subject to the statutory exceptions for mandatory treatment.

These provisions must be considered together.

They do not establish an unrestricted right to demand any preferred intervention, nor do they remove the responsibilities of healthcare professionals to provide appropriate and safe care.

Healthcare professionals must practice within their authorized scope, follow applicable professional requirements, and avoid unlawful or clinically inappropriate interventions.

A patient's preference does not require a clinician to provide a treatment that conflicts with professional standards.

Equally, professional expertise should not be used to disregard lawful patient rights or withhold information necessary for an informed decision.

It is important to distinguish ordinary discussion of lifestyle preferences from formal refusal of medical treatment.

A patient who is not ready to make a particular dietary change immediately should not automatically be treated as formally refusing medical treatment under Article 13.

Where refusal of examination or treatment occurs, the relevant counseling, documentation, and statutory requirements must be addressed according to the circumstances.

The law also provides specific arrangements for patients who are minors, experience limitations affecting legal capacity or decision-making, or require lawful representation.

Shared decision-making should not be used to justify reducing or discontinuing prescribed medication without appropriate clinical assessment.

Effective lifestyle interventions may sometimes change blood pressure, blood glucose, or other clinical parameters enough to require treatment reassessment.

Any medication changes must remain under the responsibility of appropriately authorized healthcare professionals, with suitable monitoring and attention to safety.

The aim is to support informed patient participation while preserving lawful, clinically appropriate care.

Family Involvement, Confidentiality, and Team-Based Care

Healthcare decisions are often influenced by family and social circumstances.

Family members may help patients attend appointments, prepare meals, obtain medication, or maintain daily care routines. Their involvement can be particularly useful when lifestyle interventions require ongoing support or changes in household practices.

However, family participation should not automatically replace the patient's own preferences.

An adult patient with the relevant decision-making capacity may wish to involve a spouse or another family member in understanding treatment options. Another patient may prefer to discuss sensitive matters privately.

Both preferences deserve respect, subject to applicable legal requirements.

The presence of relatives during a consultation should not automatically be interpreted as permission to disclose all personal health information.

Healthcare professionals must also recognize circumstances in which lawful representatives have defined responsibilities under Vietnamese law.

The Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/ND-CP, both effective January 1, 2026, establish requirements concerning the processing and protection of personal data.

These requirements are relevant when healthcare organizations collect, use, disclose, or otherwise process patient information, including through communication platforms and digital decision-support tools.

The applicable legal basis, confidentiality obligations, consent where required, and necessary safeguards must be considered according to the circumstances.

The wider healthcare team also has a role in supporting meaningful decisions.

Patients with several chronic conditions may receive recommendations from different professionals. Each recommendation may be clinically reasonable, yet the combined treatment burden may become difficult to manage.

Where appropriate, physicians, nurses, dietitians, pharmacists, rehabilitation professionals, and other qualified healthcare professionals can contribute information within their respective scopes of practice.

Consistent communication is important so that patients are not left to reconcile conflicting recommendations on their own.

The organization of care matters as well. Patients may benefit from understandable information before or after consultations, opportunities to ask questions, appropriate support from others, and the ability to revisit decisions as their circumstances change.

Clinical documentation should reflect relevant discussions, significant risks explained, patient preferences, decisions made, and agreed follow-up, in accordance with applicable professional and recordkeeping requirements.

However, documentation that information was provided does not necessarily demonstrate that meaningful shared decision-making occurred.

A patient who feels unable to ask questions or express disagreement may appear to have accepted a plan without genuinely participating in the decision.

For healthcare organizations, the challenge is therefore not simply to introduce the language of shared decision-making. It is to support professional practices and clinical environments in which patients can participate meaningfully.

What Shared Decision-Making Means for VLMA

For VLMA, shared decision-making is relevant to our broader objective of connecting scientific evidence with responsible healthcare practice.

Healthcare professionals need more than knowledge of which interventions can be beneficial. They also need to understand how to communicate evidence, explain reasonable alternatives, recognize uncertainty, and support decisions that reflect patients' circumstances without compromising safety.

These competencies complement clinical knowledge rather than replace it.

The international Lifestyle Medicine Core Competencies: 2025 Update continues to emphasize therapeutic relationships, collaborative care, behavior change, and attention to social determinants of health.

Shared decision-making helps connect these professional responsibilities to decisions involving individual patients.

As VLMA develops, one possible contribution is to make relevant international guidance more accessible to healthcare professionals in Viet Nam through evidence-based educational resources and practice-oriented discussions.

Future activities could examine how clinicians communicate treatment trade-offs, recognize health literacy needs, and assess decision-support materials.

Such work would need to consider Vietnamese clinical settings, professional requirements, available resources, and the involvement of appropriately qualified healthcare professionals.

These are potential directions for professional education and knowledge exchange. They do not imply that VLMA has already developed validated patient decision aids or established a clinical shared decision-making service.

VLMA does not intend to replace licensed healthcare professionals or the responsibilities of healthcare facilities.

Our aim is to support professional understanding and the responsible application of relevant evidence and principles.

From Recommendations to Informed Choices

Lifestyle Medicine recognizes that daily behaviors can influence health, but translating that knowledge into appropriate care requires more than identifying what patients should change.

Healthcare professionals need to understand which interventions are supported by evidence, how expected benefits and risks apply to individual circumstances, and where meaningful choices exist.

Patients need information they can understand and opportunities to explain what matters to them.

Shared decision-making brings these responsibilities together. It does not mean that every option is equally effective or appropriate, and it does not remove professional responsibility for clinical safety.

Nor does it require patients to make complicated medical decisions without guidance.

A good discussion allows clinical expertise and patient preferences to inform one another. It recognizes that an intervention supported by strong scientific evidence may still require careful adaptation to the person receiving it.

For VLMA, supporting evidence-based Lifestyle Medicine in Viet Nam should include encouraging healthcare professionals to communicate evidence accurately, recognize treatment burden, and respect patients' lawful choices.

This is particularly important in long-term care, where decisions often need to be revisited as health conditions, treatment needs, and personal circumstances change.

Shared decision-making is not simply about obtaining agreement with a recommendation. It is about helping patients and healthcare professionals reach clinically sound decisions that patients understand, can meaningfully participate in, and can realistically carry forward.

That principle deserves a place alongside scientific evidence, professional competence, and patient safety in the responsible development of Lifestyle Medicine in Viet Nam.

Selected References

1. National Institute for Health and Care Excellence. Shared Decision Making. NICE Guideline NG197. Published June 17, 2021.

2. Stacey D, Lewis KB, Smith M, et al. Decision Aids for People Facing Health Treatment or Screening Decisions. Cochrane Database of Systematic Reviews. 2024;1. DOI: 10.1002/14651858.CD001431.pub6.

3. Volk RJ, Lewis KB, Smith M, et al. Updated International Patient Decision Aid Standards (IPDAS Version 5.0): Modified Delphi, Evidence Informed Consensus Process. BMJ. 2026;393. Published June 12, 2026. DOI: 10.1136/bmj-2025-088116.

4. World Health Organization. Low Health Literacy Is Costing Health. Geneva: World Health Organization; December 11, 2025.

5. Nguyen BN, Ngo TT, Nguyen TLH, et al. Health and eHealth Literacy in Vietnam: Evidence From a National Survey. Patient Education and Counseling. 2026;148:109583. DOI: 10.1016/j.pec.2026.109583.

6. Ho DTA, Nguyen MT, Nguyen VQB, et al. Psychometric Properties of the Vietnamese SDM-Q-9 for Measuring Patient-Perceived Shared Decision-Making in Primary Care. Hue Journal of Medicine and Pharmacy. 2026;16(2):33–40. DOI: 10.34071/jmp.2026.2.872.

7. Bresser CC, Duarte-Díaz A, González-Pacheco H, et al. Assessing Shared Decision-Making in Clinical Practice: A Systematic Review and Meta-Analysis of Studies Using OPTION-12 and OPTION-5. BMJ Evidence-Based Medicine. 2026;31(5):300–314. DOI: 10.1136/bmjebm-2025-113830.

8. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. First published online October 28, 2025. DOI: 10.1177/15598276251379821.

9. World Medical Association. WMA Declaration of Lisbon on the Rights of the Patient. Adopted October 1981; amended September 1995; editorially revised October 2005; reaffirmed April 2015.

10. National Assembly of Viet Nam. Law on Medical Examination and Treatment No. 15/2023/QH15. January 9, 2023. Effective January 1, 2024, as amended.

11. National Assembly of Viet Nam. Law on Personal Data Protection No. 91/2025/QH15. June 26, 2025. Effective January 1, 2026.

12. Government of Viet Nam. Decree No. 356/2025/ND-CP Detailing Certain Articles and Measures for Implementing the Law on Personal Data Protection. December 31, 2025. Effective January 1, 2026.

Editorial and Professional Scope Note

This article presents the professional perspective of the Vietnam Lifestyle Medicine Alliance on shared decision-making, health literacy, treatment trade-offs, and patient choice in evidence-based Lifestyle Medicine as of October 2026. It is intended for professional information, education, and knowledge exchange.

It does not constitute a clinical practice guideline, individualized medical advice, formal treatment protocol, legally binding interpretation of patient rights, or a substitute for professional clinical judgment. The hypothetical consultation is illustrative and does not describe an actual VLMA clinical activity or identifiable patient.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. It is not a medical examination or treatment service provider, medical licensing authority, or regulatory body. VLMA does not independently diagnose patients, prescribe treatments, authorize medication changes, or provide individualized clinical decision-making services.

Clinical decisions must be made by appropriately authorized healthcare professionals within their lawful scopes of practice, taking account of the patient's condition, applicable clinical guidance, professional responsibilities, informed participation, and relevant Vietnamese law. Shared decision-making does not authorize unsafe or unlawful treatment, nor does it remove the need for timely medical intervention when clinically indicated.

References to international guidelines, patient decision aid standards, and research findings are provided for professional education. Their inclusion does not imply that those standards automatically have regulatory force in Viet Nam or that VLMA has formally adopted, validated, or implemented the programs and tools discussed.