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Shared Decision Making Tools

April 3, 2017

The following are a few useful tools for communicating risk vs. benefit about drug treatment:

  1. Bone Health (has a print-out option for patients): https://osteoporosisdecisionaid.mayoclinic.org/index.php/osteo/index?PHPSESSID=ivrnh602p4pni80teu0rjak5d4

  2. Absolute CVD Risk / Benefit Calculator: http://chd.bestsciencemedicine.com/calc2.html

  3. Stroke Prevention in Atrial Fibrillation: http://sparctool.com/

  4. Mental Health: http://medicationinfoshare.com/tools/

  5. Patient Decision Aids: https://decisionaid.ohri.ca/AZlist.html

  6. Choosing Wisely Canada: http://www.choosingwiselycanada.org/recommendations/

These tools have all been saved to CFPNA weblinks.

 

 

This article is on effective communication of risk and benefits to patients for shared decision making: Ann Intern Med 2014;161:270-08.  https://www-ncbi-nlm-nih-gov.uml.idm.oclc.org/pubmed/?term=ann+intern+med+2014%3B161%3A270

 

Main practical points from this article:

  1. Avoid general descriptive terms "rare", "common", "high", "low", "likely" - means very different things to different people

  2. Use absolute risk reduction over relative risk reduction (overestimates benefit especially for rare outcomes)

  3. If using relative risk reduction, apply the number to the patient's baseline risk

  4. Use percent (e.g., 50%) or basic frequencies (e.g., 5 in 10) (or even better, use both to improve understanding)

  5. Use visual aids (links above, bar graphs/figures, decision aids)

  6. When noting potential side effects of treatment, choose 2-3 side effects (How to choose? Choose common ones, annoying ones that can lead to non adherence but can be minimised with patient action, potential serious ones, or ones sensationalised in the media/common misconceptions)

     

     

     

     

     

     

     

     

     

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