Shared Decision-making in Health Care – Achieving Evidence-based Patient Choice (2nd ed.)

Citation

(2009), "Shared Decision-making in Health Care – Achieving Evidence-based Patient Choice (2nd ed.)", International Journal of Health Care Quality Assurance, Vol. 22 No. 5. https://doi.org/10.1108/ijhcqa.2009.06222eae.003

Shared Decision-making in Health Care – Achieving Evidence-based Patient Choice (2nd ed.)

Shared Decision-making in Health Care – Achieving Evidence-based Patient Choice (2nd ed.)

Article Type: Recent publications From: International Journal of Health Care Quality Assurance, Volume 22, Issue 5

Edited by Adrian Edwards and Glyn Elwyn,OUP,Oxford,April 2009,ISBN 978-0-19-954627-5

Keywords: Decision making, Health and medicine, Patients, Doctors

When the first edition of this book came out in 2001 (under the title Evidence-based Patient Choice: Inevitable or Impossible?), it examined the emerging themes of patient choice and clinical decision-making, and looked at how these might develop in the future. Since then, these issues have become even more topical. Evidence-based medicine is deeply ingrained in the practice of modern medicine, while patient choice is increasingly high on the political agenda. But can the two trends co-exist? “Shared decision-making” has developed in response to the sometimes uneasy relationship between a patient’s right to have input into their treatment options, and a clinician’s responsibility to provide the best evidence-based health care.

This second edition develops the same five sections as the first, examining the nature of health care, theoretical perspectives, conceptual development, evidence of shared decision-making in practice, and debating potential future developments

Imagine a patient with osteoarthritis of the knee. She and her doctor are considering whether she would benefit from surgery to replace her knee joint. This sort of decision is typical of many in health care where there is more than one reasonable alternative available to the patient and her doctor. These alternatives include surgery, physiotherapy, medication, complementary remedies, and more. What is right for one patient may be different from what is right for another. Clinical information (such as results of x-rays or even patient-reported symptom scores), though necessary, is not sufficient to determine the best treatment. Most importantly, each patient feels differently about the impact of the illness in their life and the importance of the potential good and bad outcomes of the treatment options. In these situations, the best treatment is the one that reflects what is most important to patients who are well informed about the options and potential outcomes. The shared decision-making approach helps doctors and patients to decide on the appropriate treatment.

This timely book explores shared decision-making by examining from practical and theoretical perspectives what should be part of the decision-making process, what the benefits and potential difficulties are when it is attempted, and examples of how this is achieved in real health care practice for several health conditions. Finally, it also examines how this type of health care is likely to become more commonplace in the future.

Contents include:

1. 1.

   Practical case studies from actual health care practice, covering both general and specific conditions, offer tangible examples for both patients and doctors.

2. 2.

   Practical discussion for clinicians covering skills, competences, teaching, and training exemplifies the practical and specific ways of adopting the ethos and acquiring skills for clinicians, including also working in multi-disciplinary teams.

3. 3.

   Theoretical perspectives from several social science disciplines, including psychology, sociology, ethics, and economics, analyse the strengths and weaknesses underlying this approach to health care.

4. 4.

   Shows areas where application is growing in new/increasingly important policy areas, such as informed choice and consent, health literacy, and the “expert patient programmes”.

5. 5.

   Documents the current situation and likely future developments, to help plan and deliver policy initiatives.