| Patient-centered
Resources:
General
Important:
Not
all clinical
recommendations from other sources have been reviewed for validity
and ours may or may not be uptodate, so selections below should
be viewed as representing examples of approaches and formats for
communications, etc. Feel free to contact us for details. Read
our Health
Care Information Source Cautions at Notices.
Contents
- What
matters to patients? Here's what we think »
- Delfini
Approach to Patient Decision-making »
- Recommended
Reading »
- Physician-Patient
Communications »
- Decision-making
»
- Conveying
Risk »
- Adherence
»
|
What
matters to Patients?
Here's
what we think — click here.
|
Delfini
Approach to Patient Decision-making
Studies show that physicians tend to describe decisions to patients,
but tend to exclude describing benefits, harms, risks, costs, uncertainties
and alternatives. Patient-centered care is about choice. Physicians
need to be prepared to discuss all these areas with patients.
Studies
also show that patients have individual preferences for decision
styles depending upon their unique circumstances. These styles are
autonomous, physician-directed and shared. Autonomous decision-making
is performed solely by the patient. Physician-directed means the
physician chooses. Shared decision-making is jointly performed by
physicians and patients. Patient-centered care involves the patient
in deciding which decision style to use, based on that patient's
own needs, values and preferences.
Physicians
may wish to favor a more prescriptive style where the evidence is
strong. Shared-decision making is often most optimal where there
are uncertainties and/or equally reasonable alternatives.
Patient
choice is at the heart of patient-centered care. Click here
to see our model for Patient Decision-making.
How
you communicate the differences in treatment choices in patients
hugely matters. Studies show an acceptance rate of 88% to 31%!!!
Click here to learn more about estimates of effect... (see our RRR,
ARR, NNT Tools). |
Recommended
Reading
- Physician-Patient
Communications »
- Decision-making
»
- Conveying
Risk »
- Adherence
»
|
Physician-Patient
Communications (see also Delfini
"Map" for Information & Engagement »)
Beck
RS, Daughtridge R, Sloane PD.
Physician-Patient Communication in the Primary Care Office:
A Systematic Review.
JABFP 2002. 15:25-38. The Journal of the American Board of Family
Practice. PMID: 11841136. Abstract.
Delfini commentary here.
Hall
JA; Roter DL; Katz NR.
Meta-analysis of correlates of provider behavior in medical
encounters.
Medical Care;1988, 26:657-675. PMID: 3292851.
Abstract. Delfini commentary here.
Stewart
MA.
Effective Physician-Patient Communication and Health Outcomes:
A Review
CMAJ 1995.152:1423-1433. PMID: 7728691. Abstract.
Delfini commentary here. |
| Decision-making
Epstein
RM, Alper BS, Quill TE.
Communicating evidence for participatory decision making.
JAMA. 2004 May 19;291(19):2359-66. Review. PMID: 15150208. Abstract.
Say
R, Thomson R.
The importance of patient preferences in treatment decisions —
challenges for doctors.
BMJ. 2003 Sep 6;327(7414):542-5 Full
text. Delfini commentary here. |
| Conveying
Risk (see also Delfini
Rx
Messaging Scripts™
»
)
Gigerenzer
G, Edwards A.
Simple tools for understanding risks: from innumeracy to
insight.
BMJ. 2003 Sep 27;327(7417):741-4.
PMID: 14512488. Full
text.
Paling
J.
Strategies to help patients understand risks.
BMJ. 2003 Sep 27;327(7417):745-8. PMID: 14512489. Full
text.
O'Connor AM, Legare F, Stacey D.
Risk communication in practice: the contribution of decision
aids.
BMJ. 2003 Sep 27;327(7417):736-40. PMID: 14512487. Full
text. |
Adherence
McDonald
HP, Garg AX, Haynes RB.
Interventions to enhance patient adherence to medication
prescriptions: scientific review.
Health Research Methodology Program, McMaster University School
of Graduate Studies, Hamilton, Ontario, Canada. JAMA 2002 Dec 11;288(22):2868-79
PMID: 15139471. Abstract.
Delfini commentary here.
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