Madiha Zaidi

A shared decision-making tool is an approach that allows the clinician to collaborate with the patient in reaching evidence-informed decision making. This tool permits the patient and the physician to work together in order to make health care decisions based on the patient’s 

 and can ultimately strengthen the patient-clinician relationship. It plays a vital role in patient-centered health care, granting the physician and the patient an opportunity to come up with treatment plans together.

, shared decision-making tools have the ability to increase adherence to medical treatment, enhance decision making, which in turn will improve patient satisfaction. The significance of shared decision-making tools is reinforced by the chair of Population Health Sciences at University of Utah Health, 

., who says, “If people don’t feel engaged in the decision-making process they are less likely to see the benefits of treatments. Instead, they may see them as a hassle and not fill their prescriptions or take the medications.”

The importance of a patient’s voice with respect to shared decision-making will help the physician gain a better understanding of their patient’s needs and preferences. The patient’s voice can be either 

The active voice is associated with the patient’s worries and what he/she requires in order to combat their disease

The passive voice is that of health-related information which is collected from the patient

The patient’s voice is essential in terms of what he/she expects from their treatment plan.

A couple of shared decision-making tools developed for metastatic breast cancer have enabled active patient participation in health care decisions. An example of such a tool is 

, which is primarily used during a consultation between a physician and a patient. CONNECT is a computer-based communication tool 

covered during a consultation and treatment outcome expectations. A clinical trial evaluating the tool found that CONNECT made it easier for patients to participate in their respective treatment plans and therefore left them feeling more satisfied with the care they received.

Patient Preferences for Prostate Care (PreProCare)

 is another tool that helps patient-centered treatment among prostate cancer patients. It allows patients to choose the treatment that they deem fit and that aligns with their values. This tool narrows down treatments for prostate cancer while giving patients the autonomy to choose based on their preferences. The tool works to identify the preferred features of prostate cancer treatments that will help in designing ways to help patients. The PreProCare tool improved patients’ 24-month satisfaction rate with care and decision and reduced regrets.

Madiha Zaidi is an intern with the Colon Cancer Foundation.

Articles

A shared decision-making tool is an approach that allows the clinician to collaborate with the patient in reaching evidence-informed decision making. 

Benefits of a Shared Decision-Making Tool for Colorectal Cancer Patients

Numerous challenges present themselves when a patient chooses to get screened for colorectal cancer (CRC), but we know very little about why patients may opt-out of getting screened.

 mailed to 660 patients aged 50-75 years old from the Virginia Ambulatory Care Outcome Research Network practices in June-July 2005 posed an open-ended question regarding what the most important barrier to CRC screening might be. Approximately 74% of the individuals who responded noted fear as the most important barrier to CRC screening. According to Nagelhout et al, one of the most 

 is fear, which was observed among 27.6% of responders. Other reasons included:

Patients’ outlook toward the screening procedure and the uncertainties surrounding it seemed to influence their decision to not get screened. Many individuals in the recommended CRC screening age range either 

 about why they need to get tested or they believe they don’t need to be screened because they feel ‘fine’.

 screening is equally prevalent across different racial and ethnic groups. A 

 suggest fear to serve as the most common barrier in CRC screening. Many patients expressed concern about getting infected with AIDS as a result of a medical device being inserted into their rectum. Several were reluctant to participate due to fear of anticipated pain, while others felt apprehensive about the preparation needed prior to a colonoscopy. Patients also expressed concern about being diagnosed with cancer after getting screened, fear of complications during the screening, and having an overall fear of getting a medical test done.

A significant gender-based difference has also been identified with respect to CRC screening. Women are far more likely to list fear as a barrier primarily due to negative past experiences pertaining to sexual abuse.

Health care providers need to gain a better understanding of barriers from the patient’s perspective, including psychological barriers, as well as what can be done to eliminate them. As noted by Jones et al, 

 the motivation to overcome fears relies on how passionately physicians advocate for CRC screening. Patients felt that physicians should reiterate and express the importance of CRC screening while remaining empathetic. Above all, physicians need to be mindful that many patients may need to reach a level of comfort before they agree to be screened.

Numerous challenges present themselves when a patient chooses to get screened for colorectal cancer, but we know very little about why patients may opt-out of getting screened.

Madiha Zaidi

Benefits of a Shared Decision-Making Tool for Colorectal Cancer Patients

Patient Inhibitions A Significant Barrier to Colon Cancer Screening

Latest News