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Supporting Shared Decision Making in Your Practice

Supporting Shared Decision Making in Your Practice. Peggy Chausse Neil Korsen PRISM #5 May 8, 2008. A 57 year old woman had a screening mammogram which showed a suspicious area. Biopsy showed malignant cells. How would you advise her regarding her choice of surgical approach?

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Supporting Shared Decision Making in Your Practice

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  1. Supporting Shared Decision Making in Your Practice Peggy Chausse Neil Korsen PRISM #5 May 8, 2008

  2. A 57 year old woman had a screening mammogram which showed a suspicious area. Biopsy showed malignant cells. • How would you advise her regarding her choice of surgical approach? • Radical mastectomy • Lumpectomy and radiation

  3. A 51 year old man is trying to decide whether to have a screening PSA done. How would you advise him on the pros and cons?

  4. A 35 year old woman screens positive for depression with a PHQ-9 score of 13. She has no previous history of depression. She reports that her function is very impaired by her symptoms. She is not suicidal. What treatment would you suggest? • Medication • Psychotherapy • Watchful waiting

  5. Shared Decision Making • Shared decision making is the collaboration between patients and caregivers to come to an agreement about a healthcare decision. It is especially useful when there is no clear "best" treatment option.

  6. Shared Decision Making • The caregiver offers the patient information that will help him or her: • Understand the likely outcomes of various options • Think about what is personally important about the risks and benefits of each option • Participate in decisions about medical care

  7. Preference Sensitive Care • Preference sensitive care refers to those conditions in which there are tradeoffs between benefits and risks for the patient, or the benefit/risk information is incomplete. • Patients and families, with good information, are more able to make good decisions in these situations than clinicians.

  8. 2 fold variation

  9. Resources – “Show and Tell” • Health Dialog/Foundation for Informed Medical Decisions www.healthdialog.com • National Council on Patient Information and Education www.talkaboutrx.org or www.bemedwise.org • Agency for Healthcare Research and Quality www.ahrq.gov/consumer

  10. Resources • Ottawa Personal Decision Guide www.decisionaid.ohri.ca/decguide.html • The Center for Shared Decision Making, Dartmouth-Hitchcock Medical Center www.dhmc.org/shared_decision_making.cfm • MaineHealth Learning Resource Center www.mainehealth.org

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