Shared Decision Making Flashcards
What are the key features of shared decision making?
Patient and clinician working together
Process rather than single event
Based on evidence and patient informed preferences
What are the reasons for using shared decision making?
Legal requirement
Professional obligation (good medical practice)
Evidence based
- reduces health inequalities
- reduces unnecessary prescribing or admissions or testing
Moral imperative
-patients should only be involved in decision making as much as they want to be
What are the possible consequence of not using shared decision making?
Patient unaware of options and not able to make informed decision
Doctor unaware of patient preferences
Poor decision quality which can lead to:
- opportunity costs due to resources used which were not right for the patient
- burden or harm
- poor adherence
What is preference misdiagnosis?
Patient not well informed or given options leading to receiving treatment which is NOT in-line with their preferences
What are the stages of 3 talk model used in SDM?
Builds relationship to ensure mutual trust and foundation for future
Choice talk
-patient explicitly informed of choices
Option talk
-options described in way so patient understands
Deliberation
-elicit patient reaction and preferences
Decision talk
-agree or defer decision
Review
-review results to check that treatment right for patient
How can patient act as expert during SDM?
Experience of illness
Social circumstances
Attitudes to risk
Values and preferences