Shared Decision Making

Question 1

What is Shared Decision Making?

Answer 1

“It is a process in which clinicians and patients work together to make decisionsand select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.”

Question 2

When is shared decision making most useful?

Answer 2

more than one treatment option

preference sensitive conditions

little evidence for one choice over another

Question 3

A preference-sensitive condition =

Answer 3

medical condition for which the clinical evidence does not clearly support one treatment option, and the appropriate course of treatment depends on the values or preferences of the beneficiary regarding the benefits, harms, and scientific evidence for each treatment option

Examples: stable ischemic heart disease, hip osteoarthritis, knee osteoarthritis, herniated disk and spinal stenosis, clinically localized prostate cancer (cancer that is confined to the prostate gland) and benign prostate hyperplasia (BPH).

Question 4

What are the characteristics of decision aids?

Answer 4

evidence-based, frequently updated, balanced

help patients clarify values and preferences

guide patients in communication with doctors

Question 5

Patient Decision Aids:

Answer 5

Tools that help people become involved in decision making:
> Making explicit the decision that needs to be made

> Providing information about the options and outcomes

> Clarifying personal values

Designed to complement, rather than replace, counseling from a health practitioner.

Question 6

Framework for shared decision making

Answer 6

Increase biopsychosocial emphasis

Helpful in chronic conditions

Assist in health literacy

Increase patient satisfaction, engagement, adherence and outcomes

Promote patient autonomy

Discourage paternalistic approach

Not yet widely adopted in PT