Patient Preferences and Decision Making
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Patient Preferences and Decision Making
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?
In this Discussion/Essay below, they share their experiences and the impact of patient involvement (or lack of involvement). They consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
To Prepare:
• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
• Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
NOTE: To ensure compliance with HIPAA rules,they did NOT use the patient’s real name or any information that might identify the patient or organization/practice.
In the Discussion/Essay below, a brief description of the situation they experienced and they explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, they explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, they explain the value of the patient decision aid they selected and how it might contribute to effective decision making, both in general and in the experience you described. They described how they might use this decision aid inventory in your professional practice or personal life.
Using the Discussion/Essay below, respond and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.
DISCUSSION/ESSAY THAT YOU NEED TO REPLY:
Description of Situation
After reading the Ottawa Hospital Research institute website, I decided to focus on the topic of Bipolar II disorder for inpatient decision-making topics. My decision for using Bipolar II or bipolar in general in a patient decision aide topic is due to the number of times we have had patients with severe acute manic episodes in relation to their bipolar I or II disorders and often in these acute manic phases’ patients are ultimately forced to take meds after court decision. Patients are usually and initially allowed to make decisions with their medications however when left untreated or if initial episode, manic bipolar leads to safety risks to the patients and others. Examples include lack of appetite, lack of sleep, paranoia, delusions, and psychosis if symptoms are left untreated.
Including patient preference and impact on treatment
Benefits of allowing patients to be part of and allowed to make informed decisions regarding their treatment include patient investment in treatment and being able to help providers navigate through many symptoms and which treatments have worked or not worked previously. This can reduce cost and time restraints and narrow down which treatment approaches benefit both the patient and provider for the best possible outcomes.
Further advantages of having patient engagement in shared decision making are that it increases health literacy which helps decrease cost and encourages providers to engage patients more leading to increased satisfaction of patients. O’Mara et al. (2022) mention that all healthcare providers should be educated on how to provide patient centered care and evidence-based practice approaches.
Concerns with allowing patients to make their own decisions are that they may forego treatment all together even treatment that is not medication assisted such as therapy recommendations.
Another example is when trying to force meds or when patients are on court orders and must take meds and not allowed to make unified decisions in their care, the medication may cause unwanted side effects and completely deter the patient from wanting to use any other medication in the same med class.
I feel it is important to educate and allow patients to voice concerns and have a voice in their treatment. Usually when a provider and patient work together they can find the best treatment options that provide the best possible outcomes
Value of patient decision aide and how it may contribute to effective decisions making.
I found the Ottawa patient decision aide to be very helpful and very insightful. I appreciate how it gives information about the health concern and options for treatment pharmaceutical or otherwise.
I did read an interesting study by Shoesmith et al. (2022) on shared decision making in behavioral health and it concluded that a similar approach such as shared problem solving is preference in conjunction with shared decision making. It is stated that shared decision making usually gives the patients options for treatment whereas shared problem solving is a way for different providers for the same patient to all be part of the same treatment plan and decisions. This approach would be very helpful in the behavioral health field because sometimes patients go to various facilities or have multiple providers and it may be difficult to determine what approach or treatment has been tried and works best.
O’Mara, C. S., Young, J. P., & Winkelmann, Z. K. (2022). Financial Health Literacy and the
Shared Decision-Making Process in Healthcare. International Journal of Environmental
Research and Public Health, 19(11). https://doi.org/10.3390/ijerph19116510
Shoesmith, W. D., Abdullah, A. C., Tan, B. Y., Kamu, A., Ho, C. M., Giridharan, B., Forman,
D., & Fyfe, S. (2022). Development of a scale to measure shared problem-solving and
decision-making in mental healthcare. Patient Education and Counseling, 105(7), 2480–
2488. https://doi.org/10.1016/j.pec.2022.01.005
The Ottawa Hospital Research Institute. (2019). Bipolar II decision Aide. retrieved 8/8/2022
from https://www.bipolardecisionaid.com.au/guideline/introduction.html
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