Shared Decision Making Flashcards
Give four reasons for Shared Decision Making
Legal requirement
Professional Obligation
Evidence for SDM
Moral imperative
What two things form the basis of SDM?
Evidence and patients’ informed preferences
What tool can be used in practice to ensure SDM is taking place?
Observer Option Tool
What effect will not using SDM have on the patient’s awareness?
Patient will be unaware of options, benefits/harms and consequences
What effect will not using SDM have on the doctor’s awareness?
Doctor will be unaware of patient’s values and preferences
What will not using SDM result in?
Opportunity costs
Burden and harm
Poor adherence
Preference misdiagnosis
What is preference misdiagnosis?
When a doctor forces one treatment on patient without making them aware of other options, and the patient would have preferred another, less effective option, than the one forced on them
What are two models for facilitating SDM?
3-talk model
2-experts model
What are the ‘3-talks’ which make up the 3-talk model for SDM?
Choice talk, option talk, decision talk
Who are the ‘experts’ in the 2 -expert model for SDM?
Clinician and patient
What makes up the clinician’s expertise in the 2-expert model for SDM?
Diagnosis
Prognosis and outcome probabilities
Causes of disease
Treatment options, including not doing anything
What makes up the patient’s expertise in the 2-expert model for SDM?
Experience of illness
Social circumstances
Attitudes to risk
Values and preferences
What are the limitations of clinical guidelines?
Research can be poor
Recommendations are designed to apply to populations, not individuals
There is a risk of preference misdiagnosis if patient preferences are not incorporated
