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Making sense of shared decision making

If you’ve been diagnosed with a condition, it’s natural to look to your doctor for advice about what your best treatment options are. But what if there is more than one treatment option and there is no robust evidence to say which is better? Further, what about your wants, needs and beliefs – you’re the one who is actually receiving the treatment.

These questions form the cornerstone of shared decision making, a process in which you and your doctor make decisions about your care together.

Details

  • Bringing your opinions together Bringing your opinions together

    There’s no denying that doctors are experts in their field. They undergo years of education and training, not to mention the experience they have gained spending time with patients. However, they aren’t an expert on you. They don’t know how it feels for you to live with your condition day–to-day, the circumstances of your life, or your beliefs, values and priorities. When making decisions about your health and care, all of these elements are important to think about. Good shared decision making brings both you and your doctor’s thoughts and opinions together.

  • How does shared decision making work? How does shared decision making work?

    A helpful way to make sense of shared decision making is to look at an example of when it may be used. Here, we focus on knee arthritis.

    Knowing your options

    Knee arthritis is a condition that affects your knee joint, causing it to become stiff and painful. It usually develops gradually over a number of years. Living with arthritis can be challenging – both emotionally and physically. There’s no cure for arthritis, but there are several treatments available. Non-surgical options include lifestyle changes, pain medicine and injections, physiotherapy and walking aids. A surgical option involves replacing the knee with an artificial joint.

    Weighing up the risks and benefits

    All of the above treatment options have risks and benefits. For example, losing weight and exercising to improve your knee arthritis, comes with very low risk. However, others carry more risks. For example, with surgery comes the risk of wound infections, or damage to ligaments and arteries.

    Coming to a decision

    As a patient, in order to make a decision about your treatment, you need to be fully aware of the pros and cons of each option. Your doctor understands these already and can discuss them with you, but they’re missing a vital piece of the puzzle – you. They won’t be able to fully appreciate how the pain or disability you’re experiencing affects you day-to-day. Nor will they know how it impacts your ability to get around or affect the things you want to achieve.

    Above all, it’s your body, and therefore your choice what happens to it. If there are any risks involved in a treatment that might be an option to you, it’s vital that you understand them.

    Being open with your doctor about your concerns or opinions, will enable both you and your doctor to reach a decision that’s the most suitable for you and your needs. Taking control of your health is vital and shared decision making can play a huge part in this.

    Explore our shared decision making hub for more information and advice.

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  • Resources Resources

    Further information

    Sources

    • Making shared decision-making a reality: no decision about me, without me. The King’s Fund. www.kingsfund.org.uk, published 2011
    • Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press; 2010
    • Total knee replacement: a guide for patients. British Association for Surgery of the Knee & British Orthopaedic Association. www.boa.ac.uk, published June 2007
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    Produced by Natalie Heaton, Bupa Health Information Team, November 2013.

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