What is shared decision making, and why is it important in health care? Shared decision making is a model of decision making where patients make decisions along with their health care team, based on what they learn about the benefits and risks of the options available to them for the management and treatment of their disease.
Patients are encouraged to express their preferences, which may include things like preference for taking a pill over getting medications through an infusion. Based on this, the doctor and the patient can then decide on a treatment regimen and next steps.
Research has shown that shared decision making can improve patient knowledge, satisfaction, enhance patient confidence in decisions, strengthen a sense of trust between doctor and patient, and improve health outcomes.
During this webinar, rheumatologist Liana Fraenkel, MD, adjunct professor of medicine at Yale University School of Medicine and Director, Patient Centered Population Health Research at Berkshire Health Systems, and Carole Wiedmeyer, patient researcher with the Global Healthy Living Foundation, describe the approach and best practices for shared decision making.
The speakers presented results from a study conducted with CreakyJoints and ArthritisPower members about patient preferences for rheumatoid arthritis treatment and the decision aid developed as a result. Patients and doctors then used the decision aid to foster shared decision making during clinical visits as part of the study. This example illustrates one way to help patients and care providers to work together to best match treatments with patients’ values. Dr. Fraenkel and Ms. Wiedmeyer were joined by CreakyJoints patients and staff for a one-hour webinar to discuss this topic.
Fast Facts from the Webinar
1. Research has shown that, compared to usual care, shared decision making (SDM) can:
- Improve patient knowledge around their disease and ways to manage and treat it
- Lead to greater satisfaction and enhanced patient confidence in decision making
- Lead to an increased sense of trust between doctor and patient
- Lead to improved health outcomes
2. Treat to target (T2T) means that the patient and clinician together decide on what goals are important to achieve while working together on a treatment plan to manage a specific disease.
Targets can be anything from reducing pain from a score of 7 to a score of 4 on a numerical rating scale or being able to walk on flat ground for 45 minutes at a time. Goals might also include improved blood work and biomarkers (reduced CRP levels, for example). Treatment decisions are conditional on patient preferences. For example, some patient may prefer taking their medication at home using a pen injection versus getting an infusion at an infusion center, while others may prefer trying pills versus injections. Patients may also be willing to tolerate nausea to obtain a fast-acting medication while other patients may not want to deal with nausea at all.
3. As a patient, some of the steps you can take to ensure that you are involved in the decision-making process may include:
- Ask what are other choices before deciding on a treatment plan
- Think about what matters to you. Consider asking your health care team about:
- Decision aids
- How to weigh your personal values about treatment
- Other options (in addition to medications) that may help to manage your disease (physical therapy, vaccinations, alternative/complementary medicine, etc.)
- Ask for help from clinic staff with:
- Education on medication options, including administration (how to use a pen injection or how to take your pills, how an infusion is given)
- Help navigating insurance requirements and financial assistance programs
The above are just a few takeaways from the one-hour event. Check out the embedded video above to watch the webinar in its entirety.
About the Presenters
Liana Fraenkel is an adjunct professor of medicine at Yale University School of Medicine and Director, Patient Centered Population Health Research at Berkshire Health Systems. Carole Wiedmeyer is a patient researcher with the Global Healthy Living Foundation.
Get Involved in Arthritis Research
If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.