Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T01:26:27.903Z Has data issue: false hasContentIssue false
  • English
  • Français

Engaging older people in decisions about their healthcare: the case for shared decision making

Published online by Cambridge University Press:  26 January 2012

Joanne Lally  and
Ellen Tullo
Joanne Lally*
Affiliation:
Newcastle upon Tyne NHS Foundation Hospitals Trust
Ellen Tullo
Affiliation:
Institute for Ageing and Health, Newcastle University, UK
*
Address for correspondence: Dr Joanne Lally, SDM Programme Lead, Clinical Governance and Risk Department, 3rd Floor, Peacock Hall, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP. Email: j.e.lally@ncl.ac.uk
Get access Rights & Permissions [Opens in a new window]

Summary

Shared decision making in clinical practice involves both the healthcare professional, an expert in the clinical condition and the patient who is an expert in what is important to them. A consultation involving shared decision making enables an examination of the options available, consideration of the risks and benefits whilst incorporating the values of the patient into the decision making process. A decision is aimed at, which is both clinically appropriate and is congruent with the patient's values.

Older people have been shown to value involvement, to varying degrees, in decisions about their care and treatment. The case of atrial fibrillation shows the opportunities for, and benefits of, sharing with older people decision making about their healthcare.

Keywords

shared decision makingatrial fibrillationpatient engagement
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 22 , Issue 2 , May 2012 , pp. 99 - 107
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Charles, C, Gafni, A, Whelan, T. Decision-making in the physician–patient encounter: revisiting the shared treatment decision-making model. Social Sci Med 1999; 49: 651–61.CrossRefGoogle ScholarPubMed
2Charles, C, Whelan, T, Gafni, A. What do we mean by partnership in making decisions about treatment? BMJ 1999; 319: 780–82.CrossRefGoogle ScholarPubMed
3Dudley, N. Importance of risk communication and decision making in cardiovascular conditions in older patients: a discussion paper. Qual Saf Health Care 2001; 10: i19–22.CrossRefGoogle ScholarPubMed
4Charles, C, Gafni, A, Whelan, T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social Sci Med 1997; 44: 681–92.Google Scholar
5Edwards, A, Elwyn, G (eds). Shared decision making in health care: achieving evidence-based patient choice. Oxford: Oxford University Press; 2009.CrossRefGoogle Scholar
6Department of Health. Liberating the NHS. London 2010.Google Scholar
7Department of Health. National Service Framework for Older People. London: Department of Health; 2001.Google Scholar
8Weinstein, JN, Clay, K, Morgan, TS. Informed patient choice: patient-centered valuing of surgical risks and benefits. Health Affairs 2007; 26: 726–30.CrossRefGoogle ScholarPubMed
9Coulter, A. The autonomous patient: ending paternalism in medical care. London: Stationery Office for the Nuffield Trust 2002.Google Scholar
10British Geriatrics Society. Standards of Medical Care for Older People. British Geriatrics Society; 2011 (cited 4 October 2011); available at: http://www.bgs.org.uk/index.php?option=com_content&view=article&id=35:gpgstandardsofcare&catid=12:goodpractice&Itemid=106.Google Scholar
11Wennberg, J, Gittlesohn, A. Variations in medical care among small areas. Sci Am 1982; 246: 120–34.CrossRefGoogle ScholarPubMed
12Anderson, N, Fuller, R, Dudley, N. ‘Rules of thumb’ or reflective practice? Understanding senior physicians’ decision-making about anti-thrombotic usage in atrial fibrillation. QJM: Int J Med 2007; 100: 263–69.CrossRefGoogle ScholarPubMed
13Mulley, AG. Inconvenient truths about supplier induced demand and unwarranted variation in medical practice. BMJ 2009; 339: 1007–9.CrossRefGoogle ScholarPubMed
14Barry, M, Fowler, F, Mulley, A, Henderson, J, Wennberg, J. Patient reaction to a program to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care 1995; 33: 771–82.CrossRefGoogle ScholarPubMed
15Hingorani, A, Vallance, P. A simple computer program for guiding management of cardiovascular risk factors and prescribing. BMJ 1999; 318: 101–5.Google Scholar
16Mulley, AG. Assessing patients’ utilities: can the ends justify the means? Med Care 1989; 27: S269–81.CrossRefGoogle ScholarPubMed
17Coulter, A. Do patients want a choice and does it work? BMJ 2010; 341: c4989.Google Scholar
18Bastiaens, H, Van Royen, P, Pavlic, DR, Raposo, V, Baker, R. Older people's preferences for involvement in their own care: a qualitative study in primary health care in 11 European countries. Patient Educ Counsel 2007; 68: 33–42.Google Scholar
19Department of Health. The expert patient: a new approach to chronic disease management for the 21st century. 2001 (cited September 2010); available at: http://www.expertpatients.nhs.uk/index.aspx.Google Scholar
20Edwards, A, Elwyn, G (eds). Evidence based patient choice. Oxford: Oxford University Press; 2001.CrossRefGoogle Scholar
21European Society of Cardiology. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology. Eur Heart J 2010; 31: 2369–429.Google Scholar
22O’Connor, A, Bennett, C, Stacey, D, Barry, M, Col, N, Eden, K et al. . Decision aids for people facing health treatment or screening decisions. Cochrane Collaboration 2006, Contract No. 3.Google Scholar
23Elwyn, G, O’Connor, A, Stacey, D, Volk, R, Edwards, A, Coulter, A et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ 2006; 333: 417–23.Google Scholar
24Barnato, AE, Llewellyn-Thomas, H, Peters, E, Siminoff, L, Collins, E, Barry, M. Communication and decision making in cancer care: setting research priorities for decision support/patients decision aids. Medical Decision Making 2007; 27: 626–34.CrossRefGoogle ScholarPubMed
25Barry, M, Cherkin, D, Chang, Y, Fowler, F, Skates, S. Randomised trial of a multimedia shared decision making program for men facing a treatment decision for benign prostatic hyperplasia. Disease Management Clin Outcomes 1997; 1: 5–14.Google Scholar
26Murray, E, Davis, H, Tai, S, Coulter, A, Grey, A, Haines, A. Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care. BMJ 2001; 323: 493–96.Google Scholar
27Stacey, D, Bennett, CL, Barry, MJ, Col, NF, Eden, KB, Holmes-Rovner, M, Llewellyn-Thomas, H, Lyddiatt, A, Légaré, F, Thomson, R. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2011; (10): CD001431.Google Scholar
28Frosch, D, Kaplan, R, Felitti, V. A randomised controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test. J Gen Internal Med 2003; 18: 781–87.CrossRefGoogle ScholarPubMed
29Gattellari, M, Ward, J. Does evidence based information about screening for prostate cancer enhance consumer decision making? A randomised controlled trial. J Medical Screening 2003; 10: 27–39.CrossRefGoogle ScholarPubMed
30Gattellari, M, Ward, J. A community based randomised controlled trial of three different educational resources for men about prostate cancer screening. Patient Educ Counsel 2005; 57: 168–82.CrossRefGoogle ScholarPubMed
31Myers, R, Daskalakis, C, Cocroft, J, Kunkel, E, Delmoor, E, Liberatore, M. Preparing African American men in community primary care practices to decide whether or not to have prostate cancer screening. J Nat Med Assoc 2005; 97: 1143–54.Google Scholar
32Partin, M, Nelson, D, Radosevich, D, Nugent, S, Flood, A, Dillon, N. Randomised trial examining the effects of two prostate cancer screening educational interventions on patient knowledge, preferences and behaviours. J Gen Internal Med 2004; 19: 835–42.CrossRefGoogle Scholar
33Schapira, M, Van Ruiswyk, K. The effect of an illustrated pamphlet decision-aid on the use of prostate cancer screening tests. J Family Practice 2000; 49: 418–24.Google ScholarPubMed
34Volk, R, Cass, A, Spann, S. A randomised controlled trial of shared decision making for prostate cancer screening. Archives Family Med 1999; 8: 333–40.Google Scholar
35Wolf, A, Nasser, J, Schorling, J. The impact of informed consent on patient interest in prostate-specific antigen screening. Archives Internal Med 1996; 156: 1333–36.CrossRefGoogle ScholarPubMed
36Krist, AH, Woolf, SH, Johnson, RE, Kerns, JW. Patient education on prostate cancer screening and involvement in decision making. Annals Family Med 2007; 5: 112–19.Google Scholar
37Watson, E, Hewitson, P, Brett, J, Bukach, C, Evans, R, Edwards, A et al. Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested. Patient Educ Counsel 2006; 63: 367–79.Google Scholar
38Lalonde, L, O’Connor, A, Duguay, P, Brassard, J, Drake, ER, Grover, S. Evaluation of a decision aid and a personal risk profile in a community pharmacy for patients considering options to improve cardiovascular health. J Pharmacy Prac 2006; 14: 51–62.CrossRefGoogle Scholar
39Montgomery, A, Fahey, T, Peters, T. A factorial randomised controlled trial of decision analysis and an infomation video plus leaflet for newly diagnosed hypertensive patients. Br J Gen Prac 2003; 53: 446–53.Google Scholar
40Sheridan, SL, Shadle, J, Simpson, RJ, Pignone, MP. The impact of a decision about heart disease prevention on patients’ discussions with their doctor and their plans for prevention: a pilot randomised trial. BMC Health Services Res 2006; 6: 121.Google Scholar
41Bernstein, S, Skarupski, K, Grayson, C, Starling, M, Bates, E, Eagle, K. A randomised controlled trial of information giving to patients referred for coronary angiography: effects on outcomes of care. Health Expectations 1998; 1: 50–61.Google Scholar
42Morgan, M, Deber, R, Llewellyn-Thomas, H, Gladstone, P, Cusimano, R, O’Rourke, K. Randomised controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease. J Gen Internal Med 2000; 15: 685–93.Google Scholar
43Dolan, J, Frisina, S. Randomised controlled trial of a patient decision aid for colorectal cancer screening. Medical Decision Making 2002; 22: 125–39.Google Scholar
44Pignone, M, Harris, R, Kinsinger, L. Videotape-based decision aid for colon cancer screening. A randomised controlled trial. Annals Internal Med 2000; 133: 761–69.CrossRefGoogle Scholar
45Wolf, A, Schorling, J. Does informed consent alter elderly patients’ preferences for colorectal cancer screening? Results of a randomised controlled trial. J Gen Internal Med 2000; 15: 24–30.Google Scholar
46Ruffin, MT, Fetters, MD, Jimbo, M. Preference-based electronic decision aid to promote colorectal cancer screening: results of a randomised controlled trial. Preventative Med 2007; 45: 267–73.CrossRefGoogle Scholar
47Trevena, LJ, Irwig, L, Barratt, A. Randomized trial of a self-administered decision aid for colorectal cancer screening. J Medical Screening 2008; 15: 76–82.Google Scholar
48Wakefield, CE, Meiser, B, Homewood, J, Ward, R, O’Donnell, S, Kirk, J. Randomized trial of a decision aid in individuals considering genetic testing for hereditary non-polyposis colorectal cancer risk. Cancer 2008; 113: 956–65.Google Scholar
49Fraenkel, L, Rabidou, N, Wittink, D, Fried, T. Improving informed decision-making for patients with knee pain. J Rheumatol 2007; 34: 1894–98.Google Scholar
50Man-Son-Hing, M, Laupacis, A, Gage, B, Montgomery, A, Howitt, A, Thomson, R et al. Preference-based antithrombotic therapy in atrial fibrillation: Implications for clinical decision making. Medical Decision Making 2005; 25: 548–59.Google Scholar
51McAlister, FA, Man-Son-Hing, M, Straus, SE, Ghali, WA, Anderson, D, Majumdar, SR, Gibson, P, Cox, JL, Fradette, M; Decision Aid in Atrial Fibrillation (DAAFI) Investigators. Impact of a patient decision aid on care among patients with nonvalvular atrial fibrillation. CMAJ 2005; 173: 496–501.Google Scholar
52Man-Song-Hing, M, Laupacis, A, O’Connor, AM, Biggs, J, Drake, E, Yetisir, E et al. A patient decision aid regarding antithrombotic therapy for stroke prevention in atrial fibrillation: a randomised controlled trial. JAMA 1999; 282: 737–43.CrossRefGoogle Scholar
53Thomson, RG, Eccles, MP, Steen, IN, Greenaway, J, Stobbart, L, Murtagh, MJ et al. A patient decision aid to support shared decision-making on anti-thrombotic treatment of patients with atrial fibrillation: randomised controlled trial. Qual Saf Health Care 2007; 16: 216–23.Google Scholar
54Oakley, S, Walley, T. A pilot study assessing the effectiveness of a decision aid on patient adherance with oral bisphosphonate medication. Pharmaceutical J 2006; 276: 536–38.Google Scholar