Shared Decision-making in Health Care
Achieving evidence-based patient choice
2nd Edition
Published on 7. May 2009
Book
Paperback/Softback
432 pages
978-0-19-954627-5 (ISBN)
Description
When the first edition of this book came out in 2001 (under the title Evidence-based Patient Choice: Inevitable or Impossible?), it examined the emerging themes of patient choice and clinical decision-making, and looked at how these might develop in the future. Since then, these issues have become even more topical. Evidence-based medicine is deeply ingrained in the practice of modern medicine, whilst patient choice is increasingly high on the political agenda. But can the two trends co-exist? 'Shared decision-making' has developed in response to the sometimes uneasy relationship between a patient's right to have input into their treatment options, and a clinician's responsibility to provide the best evidence-based health care. Imagine a patient with osteoarthritis of the knee. She and her doctor are considering whether she would benefit from surgery to replace her knee joint. This sort of decision is typical of many in health care where there is more than one reasonable alternative available to the patient and her doctor. These alternatives include surgery, physiotherapy, medication, complementary remedies, and more.
What is right for one patient may be different from what is right for another. Clinical information (such as results of x-rays or even patient-reported symptom scores), though necessary, is not sufficient to determine the best treatment. Most importantly, each patient feels differently about the impact of the illness in their life and the importance of the potential good and bad outcomes of the treatment options. In these situations, the best treatment is the one that reflects what is most important to patients who are well-informed about the options and potential outcomes. The shared decision-making approach helps doctors and patients to decide on the appropriate treatment. This timely book explores shared decision-making by examining from practical and theoretical perspectives what should be part of the decision-making process, what the benefits and potential difficulties are when it is attempted, and examples of how this is achieved in real health care practice for several health conditions. Finally, it also examines how this type of health care is likely to become more common place in the future.
What is right for one patient may be different from what is right for another. Clinical information (such as results of x-rays or even patient-reported symptom scores), though necessary, is not sufficient to determine the best treatment. Most importantly, each patient feels differently about the impact of the illness in their life and the importance of the potential good and bad outcomes of the treatment options. In these situations, the best treatment is the one that reflects what is most important to patients who are well-informed about the options and potential outcomes. The shared decision-making approach helps doctors and patients to decide on the appropriate treatment. This timely book explores shared decision-making by examining from practical and theoretical perspectives what should be part of the decision-making process, what the benefits and potential difficulties are when it is attempted, and examples of how this is achieved in real health care practice for several health conditions. Finally, it also examines how this type of health care is likely to become more common place in the future.
Reviews / Votes
Review from previous edition This well designed book is clear, accessible and, as one would expect from the title, evidence-based ... I think this is a great book that challenges clinicians and others working in health care to develop and adapt to a rapidly changing and demanding world. Can we do it with support from patients? The answer is in the book! Family Practice, Vol 19, No 3 Before the last chapter, evidence-based patient choice could still be an option. After it, there's simply no argument. EBPC on Bandolier This impressive edited book ... is truly excellent ... essential reading for all those interested in patient involvement and evidence-based health-care. Health Expectations, 5More details
Edition
2nd Revised edition
Language
English
Place of publication
Oxford
United Kingdom
Target group
Professional and scholarly
Edition type
Revised edition
Illustrations
38 black and white line drawings, and 5 black and white photographs
Dimensions
Height: 246 mm
Width: 170 mm
Thickness: 21 mm
Weight
708 gr
ISBN-13
978-0-19-954627-5 (9780199546275)
Copyright in bibliographic data and cover images is held by Nielsen Book Services Limited or by the publishers or by their respective licensors: all rights reserved.
Schweitzer Classification
Persons
Glyn Elwyn is a primary care clinician who has research interests in shared decision-making, decision support technologies, risk communication and the integration of health informatics into clinical practice. He has published 150 peer-reviewed articles. He was appointed as one of the inter-school Link Chairs at Cardiff University in May 2005, and leads the Clinical Epidemiology Interdisciplinary Research Group at the School of Medicine (2007). In collaboration with Professor Adrian Edwards, he convenes a research group on decision-making and the development of web-based interactive decision support materials (see www.prosdex.com, www.amniodex.com, www.bresdex.com). He is involved in the supervision of 10 PhD students. He holds a visiting chair position at 'IQ', the Scientific Institute for Quality of Healthcare, Radboud University & Medical Centre, Nijmegen, The Netherlands.He co-leads the International Patient Decision Aids Standards Collaboration with Professor Annette O'Connor, Ottawa, Canada.
Content
1. Shared decision-making in healthcare: achieving evidence-based patient choice ; 2. International collaboration in promoting shared decision making: a history and prospects ; 3. Patient involvement in decision-making: the importance of a broad conceptualisation ; 4. Shared decision making: the implications for healthcare teams and practice ; 5. Evidence-based healthcare decision making: roles for health professionals ; 6. Evidence-based health care: what roles for patients? ; 7. Using decision-making theory to inform clinical practice ; 8. Evidence and risk: the sociology of health care grappling with knowledge and uncertainty ; 9. Ethical issues around evidence-based patient choice and shared decision-making ; 10. The economics of shared decision-making ; 11. The physician-patient encounter: an agency relationship? ; 12. Decision-making, power and the doctor patient relationship ; 13. Informed choice: a construct in search of a name ; 14. Developing expert patients ; 15. Health literacy - achieving consumer 'empowerment' in health care decisions ; 16. Conceptual variation and iteration in SDM: the need for clarity ; 17. Shared decision-making: from conceptual models to implementation in clinical practice ; 18. Values clarification ; 19. Risk communication - making evidence part of patient choices ; 20. Measuring 'decision quality': irresolvable difficulties and an alternative proposal ; 21. A practical approach to measuring the quality of preference-sensitive decisions ; 22. What's happening around the world? ; 23. Medico-legal aspects of evidence-based choice and shared decision-making ; 24. Helping consumers with their information needs ; 25. Helping consumers to know their chances ; 26. Making information available to patients and the general public: the example of 'Informed Health Online' from Germany ; 27. The role of decision aids in promoting evidence-based patient choice ; 28. How effective are patient decision aids? ; 29. Examining the theoretical foundation of decision support technologies ; 30. Should patient stories be used in decision aids? ; 31. The role of internet-delivered interventions in self-care ; 32. Decision analysis - utility for everyday use? ; 33. The International Patient Decision Aids Standards (IPDAS) Collaboration: the checklist, the instrument and next steps ; 34. The decision research lab ; 35. Decision aids for preventing cardiovascular disease ; 36. Decision aids in multiple sclerosis ; 37. Decision aids / shared decision-making in Inflammatory Bowel Disease ; 38. Shared decision-making in mental health ; 39. Decision aids and shared decision-making in menorrhagia ; 40. Decision aids in diabetes ; 41. Promoting critical reflection in breast cancer decision-making ; 42. Aneurysms of the abdominal aorta ; 43. From leaflets to edutainment: the evolution of PSA decision support tools ; 44. Decision support in the treatment of prostate conditions ; 45. Decision aids and shared decision-making in mammography screening ; 46. Decision aids to promote shared decision-making for colorectal cancer screening ; 47. Shared decision-making in cardiovascular risk management: experiences and challenges ; 48. Decision aids for MMR vaccination ; 49. Supporting decisions in clinical genetics ; 50. A Devils' Advocate: do patients really want shared decision-making? ; 51. Barriers and facilitators to implementation of shared decision making ; 52. Understanding factors that retard the normalization of decision-support technologies ; 53. Education and training of health care professionals ; 54. Decision aids and beyond: the next decade of decision support technologies... ; 55. Information therapy: tomorrow's promise is happening today - an example from the commercial sector ; 56. "It's what we do around here": shared decision-making as a future organisational competence