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Shared decision making: What do clinicians need to know and why should they bother?
journal contribution
posted on 2014-07-07, 00:00 authored by T C Hoffmann, F Légaré, M B Simmons, Kevin Mc NamaraKevin Mc Namara, K McCaffery, L J Trevena, B Hudson, P P Glasziou, C B Del MarShared decision making enables a clinician and patient to participate jointly in making a health decision, having discussed the options and their benefits and harms, and having considered the patient's values, preferences and circumstances. It is not a single step to be added into a consultation, but a process that can be used to guide decisions about screening, investigations and treatments. The benefits of shared decision making include enabling evidence and patients' preferences to be incorporated into a consultation; improving patient knowledge, risk perception accuracy and patient-clinician communication; and reducing decisional conflict, feeling uninformed and inappropriate use of tests and treatments. Various approaches can be used to guide clinicians through the process. We elaborate on five simple questions that can be used: What will happen if the patient waits and watches? What are the test or treatment options? What are the benefits and harms of each option? How do the benefits and harms weigh up for the patient? Does the patient have enough information to make a choice? Although shared decision making can occur without tools, various types of decision support tools now exist to facilitate it. Misconceptions about shared decision making are hampering its implementation. We address the barriers, as perceived by clinicians. Despite numerous international initiatives to advance shared decision making, very little has occurred in Australia. Consequently, we are lagging behind many other countries and should act urgently.
History
Journal
Medical Journal of AustraliaVolume
201Issue
1Pagination
35 - 39Publisher DOI
ISSN
0025-729XeISSN
1326-5377Publication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2014, Australasian Medical Publishing CompanyUsage metrics
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No categories selectedKeywords
Science & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal MedicineHEALTH-PROFESSIONALSPATIENT PREFERENCESINTERVENTIONSFACILITATORSPERCEPTIONSKNOWLEDGELITERACYBEHAVIORBARRIERSMODELAnti-Bacterial AgentsChild, PreschoolDecision MakingDecision Support TechniquesEvidence-Based MedicineFemaleGuideline AdherenceHumansOtitis MediaPatient ParticipationPatient SatisfactionPhysician's RolePhysician-Patient RelationsProfessional-Family Relations
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