What benefits does the patient expect from a treatment? What are patients goals? What are their priorities?

Before making a choice and suggesting a treatment, it is better for healthcare professionals to ensure that the treatment(s) envisaged will help achieve the patient’s hoped-for objectives. The harm-benefit balance of the treatments envisaged is only meaningful if it is re-examined in the light of these goals.

The value of a therapy does not depend solely on its preventive, curative, symptomatic or palliative properties, but also on the concrete benefits hoped-for by the patient and the risks of adverse effects.

In practice, the purpose of a treatment is either to cure, to prevent a recurrence or a complication, to limit any deterioration, relieve distress, to reassure or even to enable a person to die in comfort and dignity.

But medical objectives are not the only ones. Patients may place great importance on other objectives – cosmetic, sexual, financial (going back to work, etc.), or the success of a personal project.

It is also important to consider the indirect beneficiaries of medicinal treatments. This applies particularly to vaccinating healthcare professionals against flu in order to protect the elderly, or children against rubella to shield pregnant women.

These different approaches should be taken into account in determining and prioritising the objectives of a treatment, in consultation with the patient.

©Prescrire 1 November 2012

"Treatment goals: discuss them with the patient" Prescrire Int 2012; 21 (132): 276-278. (Pdf, subscribers only).