Shared Decision-Making – a way to improve satisfaction, adherence, and outcomes?

 

Every PT has experienced it. The patient who isn’t improving between sessions (or even losing the gains made during your previous session). “Are you doing the exercises I gave you?” “Oh, no. I forgot where I put the sheet” (or insert any other reason you have heard). Or your patient calls and cancels multiple times in a row, or just doesn’t show up at all.

I’m reading through older journals, trying to clean out my office and learn at the same time. There is an article in the October 2013 issue of PTJ about shared decision making (SDM) which I found interesting, especially after some great CSM programming in Las Vegas this past February. SDM is “a model that reduces the unbalanced power between health professionals and patients… and has 5 characteristics:

  • at least 2 participants have to be involved
  • both parties have to take steps to participate in the process of treatment decision making
  • Information sharing is a prerequisite to shared decision making
  • Deliberation has to take place by discussing the treatment preference of both parties
  • A treatment decision has to be made and both participants have to agree upon the decision.”

SDM has been shown to improve “patient satisfaction, treatment adherence, and health outcomes.” In this study they observed the interaction between PT’s and patients in Belgium (in an outpatient self-employed setting). Interestingly, rarely was shared decision making applied or attempted by the therapists. You can read more about the study here, but there are 12 items in the instrument looking at SDM and I found them interesting and challenging in my own practice. You can read about the OPTION instrument and the items here. How often do we do these items even to a baseline skill level? Can we use the items from the OPTION instrument in improving our relationship with our patient, and thus improve the patient’s “satisfaction, treatment adherence, and health outcomes”?

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