Discussion 1: The potential impact of patient decision aids
Discussion 1: The potential impact of patient decision aids: Offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared…
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Discussion 1: The potential impact of patient decision aids
Paper details
Offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared. Please see article to respond to in the additional materials box. Resources also provided, 2 references from that list is recommended to be used in the response.
Solution
I am glad that you took a bold step to advocate for patient-centered care. It is unethical for clinicians to prejudge a patient, especially if they have a history of substance abuse. In this case, the patient was doing well after rehabilitation and had no signs of relapse. While caregivers also have an opinion on the kind of treatment a patient should have, the patient’s voice is the most important in the decision-making process. They are the ones receiving treatment and are aware of what works best for them.
Clinicians are obligated to respect the patient’s decisions, values, and beliefs to achieve quality healthcare (Kon et al., 2016). Additionally, patient-centered care can help to increase patient cooperativeness in the treatment procedures, improving their quality of life.
According to Hoffmann et al. (2014), there is a connection between evidence-based medicine and shared decision-making. In this regard, evidence-based medicine relies on facts about what has previously worked on the patient based on their opinions. Specifically, it begins with the patient, where clinicians rely on finding evidence on some of the best treatment procedures, putting them into practice, and making decisions aligned to the patient’s circumstances, values, and preferences.
On the other hand, shared decision-making involves clinicians and patients working collaboratively to discuss the available treatment options and the possible harms and benefits while considering the patient’s preferences, values, and circumstances (Hoffmann et al., 2014). In this regard, it is clear that the two concepts are interdependent to provide patient-centered care.
However, evidence-based medicine is poorly implemented where the patient’s opinions and preferences are undermined, and clinicians rely on medical evidence and their knowledge to offer treatment. As a result, patients and their providers may have conflicts when their opinions are not given enough attention. Also, patients may refuse to cooperate in treatments that are not aligned to their preferences reducing the treatment effectiveness.
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Kluetz et al. (2018) add that shared decision-making is crucial in delivering patient-centered care in healthcare settings. In this regard, clinicians should engage with patients in the decision-making process to define healthcare goals, including the life-prolonging interventions and treatment decisions that affect the patient’s beliefs and values. However, it is up to the clinician to use experience and knowledge to implement the correct diagnosis and treatment procedures (Kon et al., 2016).
The decision on the proper treatment does not rely on the patient or healthcare provider but both. In this case, the patient has a right to give an opinion on his preferences, but the provider has a responsibility to evaluate the patient’s opinions and give way forward on the best treatment. The health provider should rely on evidence-based practices to deliver quality care.
Sometimes, the patient may have a hidden agenda to get medication to fulfill their opioid abuse needs. In this case, the patient may go to the extremes to receive these medications, but they do not improve their healthcare in any way (Kon et al., 2016). In other instances, patients may have had a specific medication work for them previously, but the circumstances might have changed; maybe they are on another medication, or the condition has worsened than the previous treatment. In this case, the clinician should evaluate these opinions and share with the patient other alternative choices present and why they cannot go with the patient’s idea.
Sharing the patient’s different decisions, a clinician makes throughout the treatment process is also important in quality care delivery (Kluetz et al., 2018). The patient will feel engaged, which will build more confidence in the healthcare organization, trust in the providers, improve cooperation and increase the satisfaction levels.
Nonetheless, there are instances where patients cannot participate in decision-making processes due to critical illness, injury or they are under pain-relieving medication. In this case, it is important to discuss treatment options with their caregivers to understand some of the clinician’s factors in the treatment procedures (Kluetz et al., 2018). While caregivers may be close relatives to the patient, there are higher chances that they share similar beliefs or are aware of the patient’s preferences, which help deliver patient-centered care.
However, even with the caregivers, the health providers should use experience and evaluate the situation to provide the appropriate treatment while integrating the caregivers’ preferences (Kon et al., 2016). In case of any disagreement on what should be done, the clinicians should inform the caregivers why their opinions are ineffective in the current situations and develop a more effective treatment option.
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If the patient is sound enough to make decisions, clinicians need to consider the patient’s opinion of the caregivers (Kluetz et al., 2018). In this regard, the caregiver’s opinions may differ from what the patient wants, leading to conflicts. For instance, in the given scenario, the patient’s family was against being prescribed narcotics due to a history of drug use. Rather than seeking the patient’s opinion, the physician and the family members decided to prescribe Tylenol instead to subsidize pain.
In this case, the patient and family members had different opinions that affected his health negatively. Therefore, it is best to integrate the patient’s preferences in the most appropriate treatment procedure. Additionally, when a patient can relapse to opioid use, the health providers should closely monitor their intake to avoid substance abuse. As a result, the patient’s needs will be fulfilled while improving their quality of life.
References
- Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision-making. JAMA, 312(13), 1295. https://doi.org/10.1001/jama.2014.10186
- Kluetz, P. G., O’Connor, D. J., & Soltys, K. (2018). Incorporating the patient experience into regulatory decision-making in the USA, Europe, and Canada. The Lancet Oncology, 19(5), e267-e274. https://doi.org/10.1016/s1470-2045(18)30097-4
- Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision-making in ICUs. Critical Care Medicine, 44(1), 188-201. https://doi.org/10.1097/ccm.0000000000001396
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