Discussion: Patient Preferences and Decision Makining

Discussion: Patient Preferences and Decision Makining

Discussion: Patient Preferences and Decision Makining

Applying the best evidence to patients requires attention to their treatment preferences and specific values. Patient preferences can be influenced by social and cultural values, religious or spiritual values, personal thoughts about what entails the quality of life, personal priorities, and beliefs about health (Chang et al., 2021). Healthcare providers can incorporate patient preferences into their plans of care by obtaining their perspectives.

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In my former organization, a diabetic patient came to his regular diabetes clinic with uncontrolled hyperglycemia. The patient’s glycemic levels had been uncontrolled for the past three months, becoming a major concern. The patient was on Metformin 500 mg per oral twice daily. I enquired from the patient about his lifestyle modification practices and medication adherence. I learned that the client had challenges remembering to take the evening dose because he was working in the evening. As a result, he requested that a once-daily dose be prescribed so that he could consistently take the drug in the morning. I informed the clinician about the case, and the dose was changed to 850 mg once daily. In the next clinic visit, the patient blood glucose level had reduced, and he had achieved glycemic control with a HbA1C below 7%. Failing to consider the client’s treatment preferences may have worsened glycemic control due to ineffective medication adherence putting the patient at risk of chronic hyperglycemia complications (Chung et al., 2021).

Type 2 diabetes decision aid in adults was developed for adults taking a single medicine to control blood glucose. The options include DPP-4 inhibitors, Metformin, Pioglitazone, SGLT-2 inhibitors, and Sulfonylureas (NICE, 2015). The decision aid can be used in my professional practice to make decisions regarding treatment for patients with type 2 diabetes.

References

Chang, D. H., Wang, Y. H., Hsieh, C. Y., Chang, C. W., Chang, K. C., & Chen, Y. S. (2021). Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction. International Journal of Environmental Research and Public Health, 18(21), 11081. https://doi.org/10.3390/ijerph182111081

Chung, F. F., Wang, P. Y., Lin, S. C., Lee, Y. H., Wu, H. Y., & Lin, M. H. (2021). Shared clinical decision-making experiences in nursing: a qualitative study. BMC Nursing, 20(1), 85. https://doi.org/10.1186/s12912-021-00597-0

NICE. (2015, December 2). Type 2 diabetes in adults: Management. NICE | The National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng28/resources/patient-decision-aid-2187281197

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Discussion: Patient Preferences and Decision Making

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.

Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. **Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. **Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. **Describe how you might use this decision aid inventory in your professional practice or personal life.