Shared Decision Making- Information for Patients
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What is it?
Shared decision making (SDM) is a conversation whereby patients and doctors work together to make decisions based on what is important to patients. This may be to select a test or investigation about whether ahead with surgery. SDM ensures patients are supported to make decisions which are right for them.
Patients who are really involved in making decisions about their care have:
- fewer regrets about treatment
- better reported communication with their healthcare professionals,
- improved knowledge of their condition and treatment options
- better treatment results and an overall better experience with improved satisfaction
Shared decision making is appropriate for decisions in both primary (GP) and secondary care (hospital) settings some examples include whether to:
- undergo a screening or diagnostic test
- undergo a medical or surgical procedure
- join in self help programme
- attempt a lifestyle change
Shared decision explores the various ways to treat a problem, including ‘no treatment’ and patients may require support to weigh up the benefits and harms of the options to make the best choice for them.
Is this a new idea?
Not at all. Shared decision making has been an idea in healthcare for over thirty years. Ethical questions were raised as to whether consent for treatment was valid when a patient isn't aware of all the reasonable treatment options. Doctors are encouraged to discuss risks with patients in deciding the best option for them.
Does it work?
There is good evidence that SDM benefits patients, improving the quality and suitability of treatments. Involving patients in making decisions about their treatment helps them understand risks and side effects. It sometimes helps patients not to have an operation, but to have a different treatment instead.
When I had prostate cancer, I discussed with doctors what was the best treatment for me. We went through various types of treatment talking about the Benefits, Risks, Alternatives and whether No treatment was required. This was called the BRAN approach. For my case, shared talking helped me make the right decision for me.
Making the most of an appointment
Having a medical appointment can be daunting for patients, and perhaps more-so where decisions need to be made. Patients and doctors should aim to get the most out of each appointment. It is a good idea to think about the questions to ask before the appointment; and to make a note of them to bring along. For patients, its good to have a relative or friend with you to listen to the conversation and support you afterwards.