Patient Preferences and Decision Making

### Discussion: Patient Preferences and Decision Making

**Situation Description:**

In my experience working in a primary care setting, there was a particular case involving a middle-aged female patient with Type 2 diabetes. The patient, whom I will refer to as Ms. A, had been struggling with managing her blood sugar levels despite being on medication. During a routine check-up, she expressed frustration with her treatment plan, feeling it was not yielding the desired results and impacting her quality of life.

**Impact of Incorporating or Not Incorporating Patient Preferences, Social Determinants of Health, and Values:**

In Ms. A’s case, initially, her preferences and values were not adequately considered. The healthcare team focused primarily on clinical guidelines and medication adjustments without fully engaging Ms. A in the decision-making process. This led to her feeling disempowered and non-compliant with the treatment plan, resulting in poor blood sugar control.

After recognizing the importance of patient involvement, the healthcare team took a different approach. They held a shared decision-making session where Ms. A was encouraged to voice her concerns and preferences. During this session, it was revealed that Ms. A faced significant barriers related to social determinants of health, such as limited access to healthy food options and a lack of social support for lifestyle changes.

**Impact of Including Patient Preferences, Social Determinants of Health, and Values:**

By including Ms. A’s preferences and addressing her social determinants of health, the treatment plan was significantly improved. For example, the team connected Ms. A with a local community program that provided affordable healthy meals and a support group for individuals with diabetes. They also adjusted her medication to better fit her lifestyle and preferences. This patient-centered approach resulted in improved compliance, better blood sugar control, and a significant enhancement in Ms. A’s quality of life.

**Value of the Selected Patient Decision Aid:**

I selected the decision aid for diabetes management from the Ottawa Hospital Research Institute’s Decision Aids Inventory. This tool provided comprehensive information about the various treatment options, their benefits, and potential side effects, and it facilitated discussions about lifestyle changes and medication adjustments. The decision aid was instrumental in helping Ms. A understand her condition better and feel more confident in making informed decisions about her care.

**Contribution to Effective Decision Making:**

The decision aid contributed to effective decision making by ensuring that Ms. A had all the necessary information in an understandable format. It also helped the healthcare team structure their consultations more effectively, ensuring all aspects of Ms. A’s preferences and social circumstances were considered. This approach not only empowered Ms. A but also fostered a stronger, more collaborative relationship between her and the healthcare team.

**Use of Decision Aid Inventory in Professional Practice:**

In my professional practice, I would use the decision aid inventory as a standard tool for engaging patients in their care decisions. These aids can help bridge the gap between clinical guidelines and patient preferences, ensuring a more holistic and patient-centered approach to care. By incorporating decision aids regularly, healthcare professionals can enhance patient satisfaction, compliance, and overall health outcomes.

**References:**

– Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. *Journal of the American Medical Association, 312*(13), 1295–1296. doi:10.1001/jama.2014.10186
– Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. *Critical Care Medicine, 44*(1), 188–201. doi:10.1097/CCM.0000000000001396
– Opperman, C., Liebig, D., Bowling, J., Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. *Journal for Nurses in Professional Development, 32*(4), 176–184. doi:10.1097/NND.0000000000000483
– Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. *Health Expectations, 17*(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x
– The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/

By reflecting on these experiences and leveraging decision aids, healthcare providers can ensure more effective and patient-centered care outcomes.

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