Effect on residual kidney function of shared decision-making in selection of dialysis therapy

Abstract Background In Japan, forgoing life-sustaining treatment to respect the will of patients at the terminal stage is not stipulated by law. According to the Guidelines for the Decision-Making Process in Terminal-Stage Healthcare published by the Ministry of Health, Labor and Welfare in 2007, the Japanese Society for Dialysis Therapy (JSDT) developed a proposal that was limited to patients at the terminal stage and did not explicitly cover patients with dementia. This proposal for the shared decision-making process regarding the initiation and continuation of maintenance hemodialysis was published in 2014. Methods and results In response to changes in social conditions, the JSDT revised the proposal in 2020 to provide guidance for the process by which the healthcare team can provide the best healthcare management and care with respect to the patient's will through advance care planning and shared decision making. For all patients with end-stage kidney disease, including those at the nonterminal stage and those with dementia, the decision-making process includes conservative kidney management. Conclusions The proposal is based on consensus rather than evidence-based clinical practice guidelines. The healthcare team is therefore not guaranteed to be legally exempt if the patient dies after the policies in the proposal are implemented and must respond appropriately at the discretion of each institution.

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Agenda for adoption of the “Proposal for the Shared Decision-Making Process Regarding Initiation and Continuation of Maintenance Hemodialysis” (The Japanese Society for Dialysis Therapy, 2014) for patients who decide to withdraw from dialysis

Nihon Toseki Igakkai Zasshi ◽

10.4009/jsdt.48.705 ◽

2015 ◽

Vol 48 (12) ◽

pp. 705-712

Author(s):

Emi Fujikura ◽

Yuta Fujikura-Ouchi ◽

Mariko Miyazaki ◽

Sadayoshi Ito

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Japanese Society ◽

Maintenance Hemodialysis ◽

Decision Making Process ◽

Shared Decision ◽

Dialysis Therapy

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Shared Decision-Making in the Selection of Outpatient Analgesics for Older Individuals in the Emergency Department

Journal of the American Geriatrics Society ◽

10.1111/jgs.12207 ◽

2013 ◽

Vol 61 (5) ◽

pp. 793-798 ◽

Cited By ~ 26

Author(s):

Cameron G. Isaacs ◽

Christine Kistler ◽

Katherine M. Hunold ◽

Greg F. Pereira ◽

Mara Buchbinder ◽

...

Keyword(s):

Decision Making ◽

Emergency Department ◽

Shared Decision Making ◽

Shared Decision ◽

Older Individuals ◽

Selection Of

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Shared decision-making in selection of prosthetic aortic valve

Open Heart ◽

10.1136/openhrt-2015-000269 ◽

2015 ◽

Vol 2 (1) ◽

pp. e000269

Author(s):

Rahul Bahl

Keyword(s):

Decision Making ◽

Aortic Valve ◽

Shared Decision Making ◽

Shared Decision ◽

Prosthetic Aortic Valve ◽

Selection Of

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The need for shared decision-making in the selection of vascular access devices: an assessment of patients and clinicians

Journal of Vascular Access Devices ◽

10.2309/108300802775842212 ◽

2002 ◽

Vol 7 (3) ◽

pp. 34-39 ◽

Cited By ~ 3

Author(s):

Cynthia Chernecky ◽

Denise Macklin ◽

Katherine Nugent ◽

Jennifer L. Waller

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Vascular Access ◽

Shared Decision ◽

Vascular Access Devices ◽

Selection Of

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Factors Influencing Provider and Patient Choice of P2Y12 Inhibitor Therapy

Journal of Pharmacy Practice ◽

10.1177/0897190020966174 ◽

2020 ◽

pp. 089719002096617

Author(s):

Rebekah M. Benitez ◽

Kathleen A. Lusk ◽

S. Hinan Ahmed ◽

Stephanie A. Hartzell ◽

Bethany A. Kalich

Keyword(s):

Decision Making ◽

Adverse Effects ◽

Shared Decision Making ◽

Stent Placement ◽

Shared Decision ◽

Related Factors ◽

Once Daily ◽

Risk Of Bleeding ◽

Factors Influencing ◽

Selection Of

Background: Clopidogrel is the most commonly prescribed P2Y12 inhibitor for acute coronary syndrome (ACS) or stent placement, though ticagrelor or prasugrel may be preferred. Medication-related factors may influence selection of therapy. Objectives: To determine which factors most greatly influence cardiology-provider and patient selection of P2Y12 inhibitor to guide shared-decision making (SDM). Methods: Single-center study assessed survey responses from 32 cardiology-providers who prescribed and 105 patients who received clopidogrel, prasugrel, or ticagrelor for ACS or stent placement. Respondents ranked factors influencing P2Y12 inhibitor selection and reported preference of therapy. Patients reported experience with shared decision-making process. Results: Cardiology-providers ranked risk of bleeding, comfort/experience, and cost as most influential. Patients ranked risk of drug interaction, adverse effects, and reduction in myocardial infarction as most influential. Significant differences between cardiology-providers and patients were found for 5 of 8 factors. Cardiology-providers ranked once daily administration (p = 0.01), risk of bleeding (p = 0.002), and cost (p < 0.001) as more important than patients. Patients ranked risk of adverse effects (p = 0.007) and drug interactions (p = 0.005) as more important than cardiology-providers. Cardiology-providers prescribed ticagrelor 42.3% of the time following ACS, though 78.1% ranked it as their preferred agent. Patients were prescribed ticagrelor 9.3% of the time, though 55.7% ranked it as their preferred agent. Use of SDM was reported by 21.6% of patients and 88.5% were unaware that multiple P2Y12 inhibitors existed. Conclusion: Significant differences exist between cardiology-providers and patients regarding factors influencing P2Y12 inhibitor selection, specifically safety-related factors, once daily administration, and cost. Most patients were not involved in SDM.

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Selecting Treatment Options and Choosing Between them: Delineating Patient and Professional Autonomy in Shared Decision-Making

Health Care Analysis ◽

10.1007/s10728-019-00384-8 ◽

2019 ◽

Vol 28 (1) ◽

pp. 4-24 ◽

Cited By ~ 1

Author(s):

Emma Cave

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Treatment Options ◽

Professional Autonomy ◽

Patient Choice ◽

Shared Decision ◽

Professional Obligations ◽

Professional Control ◽

Medical Paternalism ◽

Selection Of

Abstract Professional control in the selection of treatment options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies that have potential to elevate the importance of patient and family preferences. In combination, they may be perceived by healthcare professionals as an obligation to follow patient preferences, even where doing so conflicts with other professional obligations. It is argued that a more nuanced approach to shared decision-making could help clarify the boundaries of decision-making responsibility.

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The Role of Shared Decision-Making in Audiologic Rehabilitation

Perspectives on Aural Rehabilitation and Its Instrumentation ◽

10.1044/arri21.1.15 ◽

2014 ◽

Vol 21 (1) ◽

pp. 15-23 ◽

Cited By ~ 6

Author(s):

Helen Pryce ◽

Amanda Hall

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Behavior Changes ◽

Shared Decision ◽

Patient Centered ◽

Treatment Information ◽

Centered Care ◽

Potential Risks ◽

Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

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