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Do nothing about me without me

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In 2010 the UK government announced plans to give patients in England more choice in various aspects of their health care. It is argued that it is choice of treatment that has most evidence of benefit. Recent research published in the US has suggested that patients’ lack of involvement in their clinical treatment plan can lead to misinterpretation of their needs by their doctors and results in them receiving treatment that is not the most appropriate.

The researchers found that doctors were, in fact, poor judges of their patients’ health beliefs and expectations, often making assumptions without involving the patients in discussion. There are often gaps between what patient actually want and what the doctor thinks they want.

For example, in studies of breast cancer patients, doctors thought that 71 per cent of patients rated keeping their breast as the top priority, but the figure reported by patients was just 7 per cent. Evidence shows that patients’ treatment choices alter when they become better informed of the potential consequences. A study showed that 40 per cent fewer patients with benign prostate cancer opted for surgery once they were informed of the risks of impaired sexual function.

In December 2010, a global seminar considered the role patients should play in healthcare decisions. It was argued that much of the care received by patients is based on the abilities and readiness of doctors to provide it, rather than on agreed standards of best practice or patients’ treatment preferences.

The seminar called on policymakers to adopt strategies that encourage shared decision making, known as the “nothing about me without me” approach, and to allow clinicians to stimulate a two way flow of information with patients, which can be tailored to individual patient preferences and needs.

 

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From: Beyond pharmacy blog

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