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Below you will find samples of our most recent acquisitions in Patient Preferences, grouped by resource type.
Shared Decision Making to Improve Care and Reduce Costs
January 3, 2013
A sleeper provision of the Affordable Care Act (ACA) encourages greater use of shared decision making in health care. For many health situations in which there's not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients' preferences and values. One way to implement this approach is by using patient decision aids -- written materials, videos, or interactive electronic presentations designed to inform patients and their families about care options; each option's outcomes, including benefits and possible side effects; the health care team's skills; and costs. Shared decision making has the potential to provide numerous benefits for patients, clinicians, and the health care system, including increased patient knowledge, less anxiety over the care process, improved health outcomes, reductions in unwarranted variation in care and costs, and great alignment of care with patients' values.… Continue reading
Posted in Cost, Decision Aid Effectiveness, Health Care Policy, Patient Decision Aids, Patient Preferences, SDM Implementation
Tagged ACA, CMS, Cochrane Collaborative, decision aids, Group Health, health care costs, HHS, IOM, IPDAS, Medicare, NEJM, PCORI, practice variation, shared decision making
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Patients' Preferences Matter: Stop the Silent Misdiagnosis
May 29, 2012
Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing what patients want. In fact, we will present an accumulation of evidence which shows that preference misdiagnoses are commonplace. In part, this is because doctors are rarely made aware that they have made a preference misdiagnosis. It is the silent misdiagnosis.… Continue reading
Shared Decision Making: A Model for Clinical Practice
May 23, 2012
The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk.… Continue reading
A Multicentre Randomised Controlled Trial Assessing the Costs and Benefits of Using Structured Information and Analysis of Women's Preferences in the Management of Menorrhagia
May 14, 2012
Objectives To develop decision aids to provide evidence-based information and formal preference elicitation for women with menorrhagia; and to evaluate their effects on patient outcomes, patient management and cost effectiveness.… Continue reading
Helping Pregnant Women Make Better Decisions: A Systematic Review of the Benefits of Patient Decision Aids in Obstetrics
October 16, 2011
Objectives: Patient decision aids can be used to support pregnant women engaging in shared decisions, but little is known about their effects in obstetrics. The authors aimed to evaluate the effects of patient decision aids designed for pregnant women on clinical and psychosocial outcomes. Conclusions: Patient decision aids have the potential to improve obstetric care. However, currently the evidence base is limited by the small number of studies, the quality of the studies and because they involved heterogeneous decision aids, patient groups and outcomes.… Continue reading
Posted in Decision Aid Effectiveness, Patient Decision Aids, Patient Involvement, Patient Preferences, SDM in Maternity Care, Special Populations
Tagged BMJ, decision aids, decision support, decision-making, evidence-based medicine, external cephalic version, labour analgesia, obstetrics, pregnancy, pregnant women, shared decision making, women
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Do Patients Want a Choice and Does it Work?
October 14, 2010
Nothing about me without me was the guiding principle adopted by 64 participants from 29 countries at a 1998 Salzburg Global Seminar convened to develop ideas for improving the quality of health care by involving patients. The catchphrase has now resurfaced in the coalition governments new plan for the NHS in England, which sees patient choice and shared decision making as key mechanisms to create a patient centred and quality focused NHS.… Continue reading
Education for Partnership: Developments in Medical Education
May 11, 2006
What patients and the public expect from doctors is changing. It has always been expected that medical education will teach clinical knowledge and practical skills, as well as school students and trainees in a professional culture that emphasises their responsibility to be trustworthy and act in the interest of their patients. In recent years however, many people have come to expect more. Nowadays patients expect clinicians to respect autonomy, to listen to them, to inform them, to take account of their preferences, to involve them in treatment decisions and to support their efforts in self-care. … Continue reading
What Patients Want and the Public Want from Primary Care
November 17, 2005
The UK government has stated it wants the public to help shape the future of the health service. In the run-up to the planned publication of a white paper on care outside hospitals, Patricia Hewitt, secretary of state for health in England, is leading a big public engagement exercise to "genuinely involve patients, public and staff in designing family health and social care to meet the challenges of the 21st century. The secretary of state's commitment to engaging directly with the public is commendable if it is a genuine attempt to listen and learn, but she should also take account of the extensive body of research evidence on what patients and the public want. Patients have diverse needs and expectations leading to different, and sometimes conflicting, views on priorities, but it is possible to discern themes. What does the evidence show?… Continue reading
Perspectives on Health Technology Assessment: Response from the Patient's Perspective
November 11, 2004
Health technology assessment (HTA) involves values and judgements, but there have been few attempts to seek the views of members of the public or to ensure that they have access to the results. Patients and citizens can make an important contribution to HTA by determining priorities for assessment, designing and conducting assessments and appraisals, receiving and using the findings, and engaging in debates about policy priorities and rationing. Those responsible for HTA should make greater efforts to involve the public and ensure that the findings are accessible to patients for use when making treatment choices.… Continue reading
Patient Information and Shared Decision-Making in Cancer Care
August 14, 2003
It is increasingly recognised that clinicians are not the only target audience for clinical guidelines. Patients also have a legitimate interest in learning about best practice, including evidence-based standards and treatment options. The developers of the SOR clinical practice guideline programme deserve commendation for their efforts to meet these information needs. In producing well-designed patients' versions of the guidelines, they have set a high standard that other producers of clinical guidelines would do well to emulate.… Continue reading
Sharing Decisions with Patients: Is the Information Good Enough?
January 30, 1999
Shared decision making, in which patients and health professionals join in both the process of decision making and ownership of the decision made, is attracting considerable interest as a means by which patients' preferences can be incorporated into clinical decisions. When there are several treatment options which may have different effects on the patient's quality of life, there is a strong case for offering patients choice. Their active involvement in decision making may increase the effectiveness of the treatment.… Continue reading
Partnerships with Patients: The Pros and Cons of Shared Clinical Decision-Making
April 15, 1997
The traditional style of medical decision-making in which doctors take sole responsibility for treatment decisions is being challenged. Attempts are being made to promote shared decision-making in which patients are given the opportunity to express their values and preferences and to participate in decisions about their care. Critics of shared decision-making argue that most patients do not want to participate in decisions; that revealing the uncertainties inherent in medical care could be harmful; that it is not feasible to provide information about the potential risks and benefits of all treatment options; and that increasing patient involvement in decision-making will lead to greater demand for unnecessary, costly or harmful procedures which could undermine the equitable allocation of health care resources.… Continue reading
