Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
What has your experience been with patient involvement in treatment or healthcare decisions?
share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
Navigating Information Overload: A frequent challenge is managing the information asymmetry. Patients often arrive with partial or misleading information gleaned from the internet, leading to unrealistic expectations or requesting treatments that are not clinically indicated. The professional's role then shifts to curating and contextualizing the information, which can be time-consuming.
The Impact of Lack of Involvement: Conversely, situations where a patient lacked involvement, often due to an acute crisis or paternalistic practice, resulted in lower trust and higher rates of non-adherence post-discharge. For instance, a patient whose palliative care decisions were made solely by family or providers often expressed distress or regret once lucid, highlighting the ethical imperative of autonomy.
The Role of Patient Decision Aids (PDAs)
To bridge the gap between complex clinical information and patient understanding, Patient Decision Aids (PDAs) are indispensable tools. PDAs are evidence-based interventions designed to help patients clarify their values and participate actively in making specific, deliberated choices among options.
Best Practices Informed by PDAs:
Standardizing Information Delivery: PDAs ensure that patients receive comprehensive, balanced information about all clinically relevant options, including the benefits, risks, and probabilities of outcomes for each choice. This counters the bias that can occur when information is delivered haphazardly.
Clarifying Values: Effective PDAs include exercises (e.g., worksheets, structured questions) that help patients explicitly articulate what matters most to them—e.g., longevity, quality of life, independence, or cost. This facilitates shared decision-making, where the final choice aligns the best clinical option with the patient's deeply held values.
Measuring Decisional Conflict: PDAs help identify and measure decisional conflict—the state of uncertainty a person experiences when making a health choice. High decisional conflict indicates a need for more support or clarification. Using PDAs moves the practice from simply telling patients to structuring their deliberation, ultimately leading to informed choices that align with best practices and personal goals.
Sample Answer
In healthcare, the shift toward patient involvement in treatment decisions reflects evolving cultural and technological landscapes where patients are increasingly informed. My experience indicates that while patient involvement improves compliance and satisfaction, navigating complex decisions—especially when patient preference conflicts with clinical evidence—presents significant challenges.
Experience with Patient Involvement in Decisions
My experience has consistently shown that informed patient involvement is crucial for achieving positive health outcomes, though it is not always straightforward:
Improved Adherence and Outcomes: When patients are actively engaged, they are more likely to understand the rationale behind a treatment plan and adhere to it. For example, a patient with diabetes who participates in selecting their insulin regimen based on their lifestyle (timing, frequency) shows higher compliance rates than one who is simply handed a fixed schedule. This participation fosters a sense of autonomy and partnership.