BMJ  2003;327:542-545 (6 September), doi:10.1136/bmj.327.7414.542

Clinical review

The importance of patient preferences in treatment decisions—challenges for doctors

¹ Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, ² School of Population and Health Sciences (Epidemiology and Public Health), Medical School, Newcastle upon Tyne NE2 4HH

The expectation that patients will become increasingly involved in making treatment decisions poses new challenges for doctors. This article discusses what these are and how doctors might face them

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

Introduction

Health professionals are increasingly encouraged to involve patients in treatment decisions, recognising patients as experts with a unique knowledge of their own health and their preferences for treatments, health states, and outcomes.^{1 2} Increased patient involvement, a result of various sociopolitical changes,^w1 is an important part of quality improvement since it has been associated with improved health outcomes^{3 w1-w9} and enables doctors to be more accountable to the public.

However, this poses challenges for doctors. We discuss these in relation to the competences for shared decision making that have been proposed.^{4 w10}

Methods

We made literature searches using Medline, Web of Science, PsychINFO, CINAHL, the Cochrane Library, and HMIC (key words "consumer participation," "patient participation," "decision making," "patient preferences," "shared decision making," "patient involvement in decision making"). We also searched references of articles, indexes of key journals, important texts about patient involvement, and key reviews.

We conducted informal interviews with doctors from a range . . . [Full text of this article]

Establishing a partnership

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Eliciting patients' preferences

Giving patients information

Presenting risk

Negotiating a decision in partnership with the patient

Inequalities in patient choice

Conclusions

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