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Healthcare professionals and patients: sharing decision-making

Shared decision-making requires healthcare professionals to inquire about their patients' goals and preferences, after having provided them with the information they need.

Research has shown that patients have high expectations of their doctors when it comes to providing information and gaining the skills they need to make choices based on the pros and cons of each healthcare option. But putting these principles into practice is no easy feat. It is up to healthcare professionals to break down the barriers and to make shared decision-making possible. Informing patients and getting them to participate in decisions about their own health helps them to get back in control of their lives.

What benefits is the patient expecting from a treatment? What are the treatment goals? And amongst these goals, which ones seem to be priorities? Before choosing and offering a treatment, it is best to try to answer these questions, to make sure that the planned treatment or treatments will help the patient reach his or her goals. Discussing and ranking the various clinical, functional, social or other goals of a treatment helps to better take the patient's point of view into account.

For example, accepting or declining screening for prostate cancer is a personal decision, to be made according to one's own values and preferences, after having been informed. Decision-making is deemed to be enlightened when the patient, informed about prostate cancer and about screening for it, has understood the hoped-for benefits, the harms and the disadvantages, the limitations and the uncertainties of screening, and when his decision is in keeping with his own values and preferences. A physician from Quebec who attended the Prescrire Encounters demonstrated how the pamphlet from the Collège des médecins du Québec entitled “Prostate cancer screening, it's YOUR decision!” ("Le dépistage du cancer de la prostate une décision qui vous appartient !")  contributed to enlightened decision-making. 

©Prescrire 1 August 2014

Source: "Préparer l'avenir pour mieux soigner" Rev Prescrire 2014 ; 34 (370).
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