The central theme of the concept of Shared Decision Making (SDM) is that you, the patient are an equal partner in every decision made about your health care on the principal of ‘No Decision About Me Without Me’ from the 2010 Health Act ‘Equity and Excellence: Liberating the NHS’.
What is Shared Decision Making?
More and more patients want to be involved in decisions about their own healthcare, and research has shown that, when they do so, they choose less hospital care and have better experiences.
We think Shared Decision Making (SDM) can make an excellent contribution to improving the quality of UK healthcare. People are more motivated to take advice and follow treatment plans when they understand the reasons and thinking behind their care, so treatment is more successful and they often recover quicker.
With SDM your health care providers explain all the relevant treatments and alternatives to you in order to provide the enough information so that you can choose the treatment option that suits you best and works with their lifestyle and personal beliefs and values.
The Not so Good Old Days
Historically doctors have been in a position of authority with patients playing a passive role in care.
This doctor/patient relationship is known as medical paternalism. Doctors tell patients what to do, and patients often follow the Doctors’ advice.
Relatively recently, however, a general shift has occurred in which patients are being encouraged to be more involved in their own decision-making with positive results.
A recent study have showed that prior to 2000 around only 50% of surveys performed with patients showed only a minority preferred to participate in medical-decision while after 2000 71% of studies found a majority of respondents who wanted to participate.
Many well-renowned health agencies, including the American Cancer Society and the American College of Physicians, recommend a shared decision model in their medical practices.
For some conditions a doctor will recommend a single straightforward treatment, for example, a course of antibiotics for an inner-ear infection.
But for many conditions there is no single treatment. Instead, you and your healthcare provider will have a range of options to choose from. In this case, what's best for you will be influenced by a number of factors, some medical, others more personal.
For example, you may need to consider the benefits of one or more drugs against their side effects, or choose between having an operation that has risks or living with the discomfort of the condition.When faced with complicated and often frightening health issues, it can be difficult to remember that we have a right to be involved in decisions about our treatment and our care. Your NHS healthcare provider has a duty to inform you about the options available and will advise us what they think is best. But it's you, the patient, who must decide whether a treatment is right for you.
Making the most of treatment choices requires careful thought and research. You're more likely to make the right decision if you learn more about the options available to you and the experiences of others.Your clinical team will provide you with this information.
Patient Decision Aids (PDAs) are designed to help patients make difficult decisions about their treatments and medical tests. They are used when there is no clinical evidence to suggest that one treatment is better than another and patients need help in deciding which option will be best for them.
Research shows that PDAs are really effective in helping patients make informed choices about their healthcare and increase patients’ awareness of the expected risks, benefits and likely outcomes.
In order to put shared decision making into practice, not only do healthcare workers need to change their behaviour, but patients do too. While the evidence shows that health outcomes are often better for patients who take an active role in their own healthcare decisions, relatively few patients actually do so.
Ask 3 Questions
Ask 3 Questions is a major multi-media campaign to give patients more say in their own healthcare.
Ask 3 Questions is the patient focused part of a National Shared Decision Making programme .This is a large scale transformational programme for the NHS, involving staff, clinicians, patients and the voluntary sector, that will improve the quality of care the NHS delivers to patients.
Research shows that encouraging patients to ask three simple questions leads clinicians to provide higher quality information about options and their benefits and harms.
AQuA has developed films, click here to view films, posters and other materials that will be displayed in patient area, consultation rooms and other public places. The campaign also includes information leaflets to be included in appointment letters to encourage patients to ask three key questions when they are asked to make a choice about treatment
The Ask 3 Questions are:
1. What are my options?
2. What are the pros and cons of each option for me?
3. How do I get support to help me make a decision that is right for me?
You can share your story on patient engagement websites such as Patient Opinion- http://www.patientopinion.org.uk
About Patient Opinion
Patient Opinion was founded in 2005 and since then has grown to be the UK's leading independent non-profit feedback platform for health services. Patient Opinion is about honest and meaningful conversations between patients and health services. We believe that your story can help make health services better.