scholarly journals Shared decision making: patients have a right to be informed about possible treatment options and their risks and benefits

2020 ◽  
Author(s):  
Ana Rosca ◽  
Tanja Krones ◽  
Nikola Biller-Andorno
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Treatment Options ◽  
Shared Decision ◽  
Risks And Benefits

Shared Decision Making

2021 ◽  
Author(s):  
Apurupa Ballamudi ◽  
John Chi
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Medical Information ◽  
Decision Aids ◽  
Treatment Options ◽  
Shared Decision ◽  
Patient Centered ◽  
Risks And Benefits ◽  
Benefit Patient ◽  
Risk And Benefit

Shared decision-making (SDM) is a process in which patients and providers work together to make medical decisions with a patient-centric focus, considering available evidence, treatment options, the patient’s values and goals, and risks and benefits. It is important for all providers to understand how to effectively use SDM in their interactions with patients to improve patients’ experiences throughout their healthcare journey. There are strategies to improve communication between patients and their providers, particularly when communicating quantitative data, risks and benefits, and treatment options. Decision aids (DAs) can help patients understand complex medical information and make an informed decision. This review contains 9 figures, 4 tables and 45 references Key words: Shared decision-making, decision-making, communication, risk and benefit, patient-centered, health literacy, quality of life, decision aids, option grid, pictographs.

scholarly journals Implementation of Shared Decision-Making in Australia

2016 ◽  
Vol 11 (2) ◽  
pp. 10-11 ◽  
Author(s):  
Kaye E Ervin ◽  
Irene Blackberry ◽  
Helen Haines
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Ethical Dilemmas ◽  
Treatment Options ◽  
Good Evidence ◽  
Evidence Based ◽  
Shared Decision ◽  
Evidence Based Treatment ◽  
Risks And Benefits ◽  
Potential Risks

Shared decision-making (SDM) is the process of clinicians and patients participating jointly in making healthcare decisions, having discussed evidence-based treatment options and the potential risks and benefits of each option, taking into consideration the patient’s individual preferences and values. SDM is ubiquitous in Australian healthcare policy. While there is good evidence for utilising SDM, clinicians’ knowledge of SDM, the current uptake, effectiveness and acceptability of SDM in Australia is largely unknown. The challenges perceived by clinicians to implementing SDM in clinical practice and potential moral, legal and ethical dilemmas require further debate and consideration. Abbreviations: SDM – Shared Decision-Making.

scholarly journals Patient decision aid based on multi-criteria decision analysis for disease-modifying drugs for multiple sclerosis: prototype development

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. E. H. Kremer ◽  
P. J. Jongen ◽  
S. M. A. A. Evers ◽  
E. L. J. Hoogervorst ◽  
W. I. M. Verhagen ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Shared Decision ◽  
Patient Decision Aid ◽  
Disease Modifying Drugs ◽  
Patient Decision ◽  
Further Development

Abstract Background Since decision making about treatment with disease-modifying drugs (DMDs) for multiple sclerosis (MS) is preference sensitive, shared decision making between patient and healthcare professional should take place. Patient decision aids could support this shared decision making process by providing information about the disease and the treatment options, to elicit the patient’s preference and to support patients and healthcare professionals in discussing these preferences and matching them with a treatment. Therefore, a prototype of a patient decision aid for MS patients in the Netherlands—based on the principles of multi-criteria decision analysis (MCDA) —was developed, following the recommendations of the International Patient Decision Aid Standards. MCDA was chosen as it might reduce cognitive burden of considering treatment options and matching patient preferences with the treatment options. Results After determining the scope to include DMDs labelled for relapsing-remitting MS and clinically isolated syndrome, users’ informational needs were assessed using focus groups (N = 19 patients) and best-worst scaling surveys with patients (N = 185), neurologists and nurses (N = 60) to determine which information about DMDs should be included in the patient decision aid. Next, an online format and computer-based delivery of the patient decision aid was chosen to enable embedding of MCDA. A literature review was conducting to collect evidence on the effectiveness and burden of use of the DMDs. A prototype was developed next, and alpha testing to evaluate its comprehensibility and usability with in total thirteen patients and four healthcare professionals identified several issues regarding content and framing, methods for weighting importance of criteria in the MCDA structure, and the presentation of the conclusions of the patient decision aid ranking the treatment options according to the patient’s preferences. Adaptations were made accordingly, but verification of the rankings provided, validation of the patient decision aid, evaluation of the feasibility of implementation and assessing its value for supporting shared decision making should be addressed in further development of the patient decision aid. Conclusion This paper aimed to provide more transparency regarding the developmental process of an MCDA-based patient decision aid for treatment decisions for MS and the challenges faced during this process. Issues identified in the prototype were resolved as much as possible, though some issues remain. Further development is needed to overcome these issues before beta pilot testing with patients and healthcare professionals at the point of clinical decision-making can take place to ultimately enable making conclusions about the value of the MCDA-based patient decision aid for MS patients, healthcare professionals and the quality of care.

scholarly journals An Exploratory Pilot Study to Describe Shared Decision-Making for PTSD Treatment Planning: The Provider Perspective

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 467-475 ◽  
Author(s):  
Bella Etingen ◽  
Jennifer N Hill ◽  
Laura J Miller ◽  
Alan Schwartz ◽  
Sherri L LaVela ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Planning ◽  
Shared Decision Making ◽  
Treatment Plan ◽  
Treatment Options ◽  
Shared Decision ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Treatment Readiness ◽  
Ptsd Treatment

Abstract Objective To describe current practices used by Veterans Administration (VA) mental health (MH) providers involved in post-traumatic stress disorder (PTSD) treatment planning to support engagement of veterans with PTSD in shared decision-making (SDM). Methods Semi-structured interviews with MH providers (n = 9) were conducted at 1 large VA, audio-recorded, and transcribed verbatim. Transcripts were analyzed deductively, guided by a published account of the integral SDM components for MH care. Results While discussing forming a cohesive team with patients, providers noted the importance of establishing rapport and assessing treatment readiness. Providers’ clinical knowledge/expertise, knowledge of the facility’s treatment options, knowledge of how to navigate the VA MH care system, and patient factors (goals/preferences, factors influencing treatment engagement) were noted as important to consider when patients and providers exchange information. When negotiating the treatment plan, providers indicated that conversations should include treatment recommendations and concurrent opportunities for personalization. They also emphasized the importance of discussions to finalize a mutually agreeable patient- and provider-informed treatment plan and measure treatment impact. Conclusion These results offer a preliminary understanding of VA MH providers’ facilitation of SDM for PTSD care. Findings may provide insights for MH providers who wish to engage patients with PTSD in SDM.

Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations

2018 ◽  
Vol 42 (4) ◽  
pp. 378-386 ◽  
Author(s):  
Matthew Quigley ◽  
Michael P Dillon ◽  
Stefania Fatone
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Development Process ◽  
Decision Aids ◽  
Treatment Options ◽  
International Standards ◽  
Shared Decision ◽  
Patient Decision ◽  
Partial Foot Amputation

Background: Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. Objectives: To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Conclusion: Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

Achieving shared treatment decisions

2017 ◽  
Author(s):  
Martin H.N. Tattersall ◽  
David W. Kissane
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Treatment Options ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Shared Decision ◽  
Similar Treatment ◽  
Treatment Benefits ◽  
Patient Values

The respect of a patient’s autonomous rights within the model of patient-centred care has led to shared decision-making, rather than more paternalistic care. Understanding patient needs, preferences, and lifestyle choices are central to developing shared treatment decisions. Patients can be prepared through the use of question prompt sheets and other decision aids. Audio-recording of informative consultations further helps. A variety of factors like the patient’s age, tumour type and stage of disease, an available range of similar treatment options, and their risk-benefit ratios will impact on the use of shared decision-making. Modifiable barriers to shared decision-making can be identified. Teaching shared decision-making includes the practice of agenda setting, use of partnership statements, clarification of patient preferences, varied approaches to explaining potential treatment benefits and risks, review of patient values and lifestyle factors, and checking patient understanding–this sequence helps both clinicians and patients to optimally reach a shared treatment decision.

scholarly journals Key components of shared decision making models: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031763 ◽  
Author(s):  
Hanna Bomhof-Roordink ◽  
Fania R Gärtner ◽  
Anne M Stiggelbout ◽  
Arwen H Pieterse
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Healthcare Professional ◽  
Shared Decision Making ◽  
Treatment Options ◽  
Healthcare Setting ◽  
Shared Decision ◽  
Eligibility Criteria ◽  
Choice Awareness ◽  
Over Time

ObjectivesTo (1) provide an up-to-date overview of shared decision making (SDM)-models, (2) give insight in the prominence of components present in SDM-models, (3) describe who is identified as responsible within the components (patient, healthcare professional, both, none), (4) show the occurrence of SDM-components over time, and (5) present an SDM-map to identify SDM-components seen as key, per healthcare setting.DesignSystematic review.Eligibility criteriaPeer-reviewed articles in English presenting a new or adapted model of SDM.Information sourcesAcademic Search Premier, Cochrane, Embase, Emcare, PsycINFO, PubMed, and Web of Science were systematically searched for articles published up to and including September 2, 2019.ResultsForty articles were included, each describing a unique SDM-model. Twelve models were generic, the others were specific to a healthcare setting. Fourteen were based on empirical data, 26 primarily on analytical thinking. Fifty-three different elements were identified and clustered into 24 components. Overall, Describe treatment optionswas the most prominent component across models. Components present in >50% of models were:Make the decision (75%),Patient preferences (65%),Tailor information (65%),Deliberate (58%), Create choice awareness (55%), andLearn about the patient(53%). In the majority of the models (27/40), both healthcare professional and patient were identified as actors. Over time,Describe treatment optionsandMake the decisionare the two components which are present in most models in any time period.Create choice awarenessstood out for being present in a markedly larger proportion of models over time.ConclusionsThis review provides an up-to-date overview of SDM-models, showing that SDM-models quite consistently share some components but that a unified view on what SDM is, is still lacking. Clarity about what SDM constitutes is essential though for implementation, assessment, and research purposes. A map is offered to identify SDM-components seen as key.Trial registrationPROSPERO registration CRD42015019740

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