Shared decision making: The best path toward medication compliance Sara E. Dugan, Pharm.D., BCPP, BCPS April 3, 2018 Option 1

objectives To identify the steps in the shared decision making process To describe how shared decision making can fit into treatment plans To outline at least one example of where shared decision making can be used

What is shared decision making ?

What is shared decision making (SDM)? ‘…an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences.’ interactive process in which clients and treatment team members work together to make a decision Elwyn G, Laitner S, Coulter A, Walker E, Watson P, et al. Implementing shared decision making in the NHS. BMJ 2010;341:c5146. Adams JR, Drake RE. Shared Decision-Making and Evidence-Based Practice. Comm Ment Health Journal 2006;42(1):87-105.

Confront a decision to be made Image from: http://a-question-of-influence.wikispaces.com/Standing+at+the+Crossroads Accessed April 25, 2016.

Steps of shared decision making Image from: Veronique. Wikispaces [Internet]:https://stfrancis1.wikispaces.com/Veronique Accessed April 25, 2016.

Steps of shared decision making Preparation and information gathering Discussion and generating a decision Re-evaluation and revisions

Preparation and Information Gathering How involved does the client wish to be in making this decision? What values, preferences or goals does the client have that influence this decision? Client Provider Participation and Preference Capacity

Preparation and Information Gathering Brainstorm all the options you can think of What questions does the client need answered regarding this decision? Utilize decision aids Image from: http://rt3region7.ncdpi.wikispaces.net/The+Paideia+Seminar. Accessed April 25, 2018.

SDM Worksheet

Discussion and generation of a decision Review information Talk through and narrow down the options Utilize the Ottawa Decision Guide Make the decision Image from: http://tse1.mm.bing.net/th?&id=OIP.M9ef7b4a78a00ae3a09c0e616972510b6H0&w=245&h=188&c=0&pid=1.9&rs=0&p=0&r=0 Accessed April 25, 2016. Image from: http://thecollaboratory.wikidot.com/philosophy-of-thought-and-logic-2011-2012 Accessed April 25, 2016.

Re-evaluation and revision Check back in What are the benefits from the decision made? What are the consequences seen of the decision made? Is a change necessary? Image from: http://sustituciondepuestosclaves.wikispaces.com/ Accessed April 25, 2016

Confront a decision to be made http://a-question-of-influence.wikispaces.com/Standing+at+the+Crossroads Accessed April 25, 2016

Example Heather is working with a new client to the community mental health clinic. The client is considering whether or not to continue on their antipsychotic medication. DECISION POINT Information gathering Decision aids Review and generate a decision Re-evaluate Image available at: http://krucina-period4-geneticdisorders.wikispaces.com/ADHD-Rehab Accessed April 25, 2016.

Thank you! Any Questions? Image from: http://shanatalks.wordpress.com/2012/04/ Accessed April 25, 2016.