Foundation for Informed Medical Decision Making in the US has changed it name and launched a new web site. As of February2012, the organisation becomes known as the Informed Medical Decisions Foundation. The Informed Medical Decisions Foundation has been working for over two decades to advance evidence-based shared decision making through research, policy, clinical models and patient decision aids. New features of the website include a comprehensive collection of shared decision making research.
This research investigates whether physicians’ recommendations pull patients away from their preferred treatment option when making a preference-sensitive decision. In the decision scenario, about 48% of patients with schizophrenia and 26% of patients with multiple sclerosis followed the advice of their physician and thus chose the treatment option that went against their initial preferences. Patients who followed their physician’s advice were less satisfied with their decision than patients not following their physician’s advice.
The Health Foundation has this week published a report on the things the Commissioning Board should do to promote shared decision making with patients. The case for ‘no decision about me, without me’ is clear in ethics and in policy and is supported by a growing evidence base. However, to make it an everyday experience for patients requires a significant change in philosophy, in culture and in the roles of patients and professionals. This fundamental shift must be modelled and led by every part of the system to drive change in government and in the consulting room. In the report, the Health Foundation briefly introduce the concept of shared decision making and then look at each of these four areas of action for the NHS Commissioning Board.
There is quite a bit of evidence about best ways to convey risk information to help with policy or clinical decision making. Pictographs and bar graphs along with numbers and descriptions are considered best. Some emerging research suggests that some elements will help some patients more than others (for instance people with low numeracy). The Mayo Clinic shared decision making resource centre has and article this week about communicating risk using visual means, including ten steps to better risk communication.
Research: A systematic review of interventions to enhance shared decision making in routine clinical practice
This systematic review evaluates the effectiveness of interventions to improve health professionals’ adoption of shared decision making in routine clinical practice, as seen by patients. The authors concluded that multifaceted interventions that include educating health professionals about sharing decisions with patients and patient-mediated interventions, such as patient decision aids, appear promising for improving health professionals’ adoption of shared decision making in routine clinical practice as seen by patients.
How to deliver high-quality, patient-centred, cost-effective care: Consensus solutions from the voluntary sector
This Kings Fund publication is the collective effort of ten of the leading health and social care organisations in the voluntary sector. Each organisation submitted evidence to The King’s Fund, which independently analysed and assessed each submission and worked with the organisations to establish a common position. Together they have identified the five key themes that the health and social care system must embrace to be sustainable and to ensure quality. The themes include patients engaged in decisions about their care, supported self-management and emotional, psychological and practical support. The report includes a section on information.
The objective of the research was to explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision-making processes. Researchers found a complex and diverse picture of decision making. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as ‘irreversible’ and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working.
In November 2011, the Royal College of Physicians hosted a workshop to explore issues surrounding
shared decision making (SDM) in clinical practice. Their report, Shared decision making, captures some of the learning from the event and outlines key themes discussed and debated on the day. The workshop was planned in partnership with the Health Foundation and The King’s Fund. The RCP invited key theoreticians in the field of shared decision making, and leaders in national programmes delivering partnership approaches to care, plus representatives from the medical royal colleges and specialist societies, to explore what this means both for patients, and for clinicians and their practice.
This article in this weeks BMJ, discusses why shared decision making is important and highlights some examples of best practice. The authors explore best practices for implementation, including patient decision aids and short decision support tools, and simple strategies for individual clinicians and debate what the medical profession can do.
The NHS Right Care shared decision making programme has announced the new contractors for the forthcoming Shared Decision Making Programme delivery. It is hoped that delivery of the elements required within these contracts should result in a step change in the delivery of shared decision making. The work includes the development of patient decision aids and embedding shared decision making in routine NHS systems. Right Care have also published an Essential Reading series on shared decision making.