Sharing decisions with patients: is the information good enough?

BMJ 1999;318:318-322 ( 30 January )

Education and debate

Sharing decisions with patients: is the information good enough?

Editorial by Richards and Coulter

Angela Coulter, director of policy and development, ^a Vikki Entwistle, senior research fellow, ^b David Gilbert, research officer. ^a

^a King's Fund, London W1M 0AN, ^b Health Services Research Unit, University of Aberdeen, Aberdeen AB25 2ZD

Correspondence to: Dr Coulter acoulter@kehf.org.uk

The first 150 words of the full text of this article appear below.

Shared decision making, in which patients and health professionals join in both the process of decision making and ownershipof the decision made, is attracting considerable interest as ameans by which patients' preferences can be incorporated intoclinical decisions.¹ When there are several treatment optionswhich may have different effects on the patient's quality of life,there is a strong case for offering patients choice. Their activeinvolvement in decision making may increase the effectivenessof thetreatment.

Trials are currently under way to test this hypothesis formally, but there are good grounds for optimism. Patients with hypertensionbenefit if they are allowed to adopt an active rather than a passiverole in treatment, ² ³ patients with breast cancer sufferless depression and anxiety if they are treated by doctors whoadopt a participative consultation style,⁴ and patients whoare more actively involved in discussions about the managementof their . . . [Full text of this article]

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