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Patient Involvement
Patient involvement refers to the role the patient plays in the medical decision making process. Many factors come into play that affect how much influence the patient has in the decision making process, including how and when the patient is involved in the process and the desire of the patient to take an active role in their care.
Our Library
Below you will find samples of our most recent acquisitions in Patient Involvement, grouped by resource type.
Building Patient-Centeredness in the Real World: The Engaged Patient and the Accountable Care Organization
May 30, 2012
The accountable care organization began life as a catchphrase signifying a shift in the relationship between a hospital and its doctors. By forming an ACO, a hospital and medical staff shared clinical and financial responsibility for coordinating care to improve quality and lower costs. The patient's role was essentially passive, like a car door that ends up with fewer dents and nicks thanks to better management of the auto assembly line. … Continue reading
Patient Engagement -- What Works?
April 5, 2012
The author discusses the recent focus on the need for patient engagement in health care, specifically the need for patients to play an active role in their own health care. Patients should be fully informed about their health care and work with their provider to make the decision that is right for them. The author discusses how health literacy, shared decision making and quality improvement are all related to the concept of patient engagement. The author also focuses on evidence in support of interventions designed to engage patients in their health care.… 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
Implementing Shared Decision Making in the NHS
July 25, 2010
Policies to promote shared decision making are becoming prominent in the United States, Canada, and United Kingdom. This is partly because of a recognition of the ethical imperative to properly involve patients in decisions about their care and partly because of the acrruing evidence that the approach has benefits. Shared decision making is an approach where clinicians and patients make decisions together using the best available evidence.… Continue reading
Implementing Shared Decision Making in the UK: A Report for the Health Foundation
April 1, 2009
Shared decision making (SDM) is a process in which patients are encouraged to participate in selecting appropriate treatments or management options. Not being properly told about their illness and the options for treatment is the most common cause of patient dissatisfaction. Most patients nowadays want more information and a greater say in decisions about how they will be treated. In SDM, patients are involved as active partners with the clinician in clarifying acceptable medical options and choosing a preferred course of clinical care.… Continue reading
Where are the Patients in Decision-making about Their Own Care?
May 11, 2008
Occasionally, all citizens have to make important health decisions that affect health outcomes. Strategies to support patient education and engagement should therefore be a fundamental plank of health policy. Also, patients can play an important role in understanding the causes of illness, protecting their health and taking appropriate action, choosing appropriate treatments for acute episodes of ill health, and managing chronic illness. These roles must be recognized and supported.… Continue reading
When Should You Involve Patients in Treatment Decisions?
October 1, 2007
There is much evidence that engaging patients in treatment decisions and supporting their efforts at self-care can lead to beneficial outcomes. Patients who are active participants in a shared decision-making process have a better knowledge of treatment options and more realistic perceptions of likely treatment effects. The resulting treatment choices are more likely to concur with their preferences and attitudes to risk. Actively engaged patients are also more likely to adhere to treatment recommendations, and less likely to select expensive procedures. However, patients' desires to play and active role in decision making varies, and, according to Cox et al., GPs are not very good at predicting what role patients want to play. What should be done about this problem?… Continue reading
Effectiveness of Strategies for Informing, Educating, and Involving Patients
April 28, 2007
Policymakers increasingly believe that encouraging patients to play a more active role in their health care could improve quality, efficiency, and health outcomes. But critics have dismissed talk about patient engagement and patient centred care as political correctness -- a misplaced concern with the "touchy feely" aspects of health care, with no scientific basis and little relevance to the quest for excellence in clinical care. Who is right? To what extent is the planned shift towards greater patient engagement supported by robust research evidence?… Continue reading
Assessing the Quality of Information to Support People in Making Decisions about Their Health and Healthcare
November 1, 2006
Good quality health information is essential for greater patient involvement in healthcare. Patients and the public require information that is timely, relevant, reliable and easy to understand. This is an essential component of any strategy to promote health literacy, self-care, choice- shared decision-making, medication adherence and self-management of chronic disease. Patients have many decisions to make about their healthcare and, like all decision-makers, they require information to inform their choices. Reliable information is also essential to help patients understand their health problems and how to deal with them.… Continue reading
Patient-focused Interventions: A Review of the Evidence
August 1, 2006
Patient-focused interventions are those that recognise the role of patients as active participants in the process of securing appropriate, effective, safe and responsive healthcare. There is a growing belief among policy-makers that patients/citizens can contribute to quality improvement at both an individual and a collective level.… 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
Engaging Patients in Their Healthcare: How is the UK Doing Relative to Other Countries
April 11, 2006
Most patients want to play an active role in their own healthcare. They want to know how to protect and improve their health when they are well; when they are ill they want information about the treatment options and likely outcomes; and, in addition to seeking fast effective health advice and care when they need it, most people also want to know what they can do to help themselves.… 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
European Patients' Views on the Responsiveness of Health Systems and Healthcare Providers
August 11, 2005
Health systems throughout the world are searching for ways of making their services more responsive to patients and the public. The WHO has been encouraging this by including indicators of responsiveness in its World Health Reports. Many European governments have recognized that the future of socialized health care services depends on their ability to keep abreast of changing needs and respond to these in an appropriate way in order to sustain public confidence. Regular surveys of the views and experiences of patients and the public are beginning to be seen as an indispensable addition to the panoply of performance indicators used for monitoring the effectiveness of health policy. We report here a survey of random population samples in eight European countries focusing on public views of the quality of doctor-patient communications and opportunities for involvement in choice of providers and treatments.… Continue reading
Full Engagement in Health
November 18, 2004
In his review of future funding needs for the British NHS, Derek Wanless called for a new focus on moderating demand by investing in effective health promotion and disease management with the active involvement of individual patients and local communities. The fully engaged scenario, which entailed a radical change in professional and public roles, was the most ambitious of the three alternatives modelled by his team, but they concluded that it offered the best and most cost effective means of matching demand to supply of health care in the longer term.… Continue reading
Posted in Cost, Health Care Policy, Patient Involvement, SDM Implementation
Tagged Angela Coulter, BMJ, health care, health policy, NHS, patients, primary care, shared decision making, UK
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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
What do Patients Want from High-quality General Practice and How do We Involve Them in Improvement?
October 14, 2002
Patient involvement is being encouraged by the government and by others as a way of improving the quality of the service provided in general practice. Patients can be involved in their own individual care; for example, in treatment decision making and in disease management; or collectively, by providing feedback on aspects of practice organisation and quality.… Continue reading
Patients' Views of the Good Doctor
September 28, 2002
Most doctors are good doctors in the eyes of most patients. Despite the media's fixation with medical errors and damaged patients, doctors come high in popularity stakes in almost any poll, compared with other professions or trades. Furthermore, familiarity tends to breed contentment, not contempt. Patients who have recent experience of medical care tend to give higher, less critical ratings than patients who experience is less current. The medical profession does, however, attract criticism from patients -- sometimes deservedly so.… Continue reading
Posted in Patient Involvement
Tagged Angela Coulter, BMJ, doctors, health care providers, medical decisions, patients
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After Bristol: Putting Patients at the Centre
March 16, 2002
Improving responsiveness to patients has been a goal of health policy in the United Kingdom for several decades. Until now, most initiatives in this area have failed to change noticeably the everyday experience of most patients in the NHS. The harsh realities of budgetary pressures, staff shortages, and other managerial imperatives tend to displace good intentions about informing and involving patients, responding quickly and effectively to patients' needs and wishes, and ensuring that patients are treated in a dignified and supportive manner. This is the essence of patient centred care, and most health professionals strive to achieve it.… Continue reading
Randomised Controlled Trial of an Interactive Multimedia Decision Aid on Benign Prostatic Hypertorphy in Primary Care
April 6, 2001
The rationale for decision aids is addressed in the accompanying paper. Unlike hormone replacement therapy, prostate surgery is a "Rubicon" procedure -- that is, once undertaken it cannot be reversed. In the United States, a pilot study on the impact of a programme to aid in decisions about benign prostatic hyperplasia showed a 40% decrease in surgery rates. This finding was not replicated in a subsequent randomised controlled trial.… Continue reading
Randomized Controlled Trial of an Interactive Multimedia Decision Aid on Hormone Replacement Therapy in Primary Care
April 6, 2001
Decision aids to assist patients in deciding about health care have been welcomed as one solution for improving doctor-patient communication, providing information for patients, and addressing the shortcomings in much of the information available. Both patient outcomes and the rational use of health service resources may be improved by better provision of information.… Continue reading
Patient Choice Modules for Summaries of Clinical Effectiveness: A Proposal
March 17, 2001
Evidence based health care has become the accepted basis of good clinical practice, and many efforts are being made to implement it. Evidence based patient choice, defined as offerring patients research based information and the opportunity to influence decisions about their treatment and care, has yet to achieve the same status. We believe, however, that is is fundamental to high quality patient care.… 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
Evidence Based Patient Information Is Important, So there Needs to be a National Strategy to Ensure it
July 25, 1998
Leaflets and other information packages (video and audio tapes, computer programs, and websites) have long been seen as integral to educational strategies designed to promote health, persuade people to adopt healthy lifestyles, and increase uptake of screening. They have also been developed to educate patients in self care of such chronic conditions as arthritis, hypertension, stress related psychological problems, gastrointestinal diseases, and back pain, and how to take medicines correctly. There is now growing interest in providing information to support patients' participation in choosing treatments and deciding on strategies for managing their health problems. … 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
Using Interactive Videos in General Practice to Inform Patients about Treatment Choices: A Pilot Study
December 15, 1995
Our objective was to assess the acceptability of using an interactive video system in a general practice setting to inform patients about treatment choices. A descriptive cohort study was carried out in eight general practices in Oxfordshire. Fifty-four patients with mild hypertension and 29 with benign prostatic hypertrophy were studied. Patients' views of the video, treatment preference, level of involvement in treatment decision and satisfaction with decision-making process and GP's views of the effect of the video on subsequent consultations were measured.… Continue reading
Posted in Decision Aid Components, Decision Aid Effectiveness, Patient Decision Aids, Patient Involvement, SDM Implementation
Tagged Angela Coulter, benign prostatic hypertrophy, decision-making, general practice, informed decisions, informed patients, interactive videos, patients, treatment decisions, UK
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