Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
What has your experience been with patient involvement in treatment or healthcare decisions?
In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
Addressing Complexity with Patient Decision Aids (PDAs)
The core challenge, as noted in the prompt, is that complexity and vast amounts of online information can confuse patients, leading to anxiety or biased decision-making. This is where a Patient Decision Aid (PDA) becomes a best practice tool.
Utility of Patient Decision Aids (PDAs)
A PDA is an evidence-based tool designed to help patients clarify their values and participate in decision-making when there are multiple reasonable treatment options.
Key Components and Best Practices:
Present All Options: A good PDA describes the condition and all available, medically appropriate options, including the choice of "doing nothing" or watchful waiting.
Provide Probabilities: It uses unbiased, clear language (often with visual aids) to describe the benefits, risks, and side effects associated with each option, typically using natural frequencies (e.g., 5 out of 100 people) rather than percentages.
Clarify Values: It includes exercises (e.g., worksheets, ranking scales) that prompt the patient to think about what matters most to them—for example, ranking mobility over pain relief, or avoiding surgery at all costs.
Check Understanding: It concludes by encouraging the patient to formulate questions for their provider and confirms they are ready to discuss the options.
By using PDAs, health professionals can ensure that the patient's pre-consultation knowledge is grounded in balanced evidence, making the subsequent conversation more focused, productive, and truly "shared."