shared decision making in health in catalonia

Moharra M1; Pons JMV; Bañeres J2; Fontcuberta JM2; Costa N3

1.Agency for Healthcare Quality and Assessment of Catalonia; 2. Fundació Avedis Donabedian; 3.Catalan

Patient Advisory Council

Shared Decision Making in Catalonia:

a new step forward in improving decision making process

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Shared Decision Making

At least two participants: physicians and patients are involved

Both parties share information

(evidence based information about treatment options, cons and pros,

patient preferences and values.)

An agreement is reached on the treatment to implement

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Background

Cultural change

(physician-patient relationship)

Internet use and new ICT

(ensure quality of information)

Patients’ right and patient autonomy

Improving health literacy and numeracy

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Patient Decision Aids (DA)

Provide information about the available options on diagnosis

(screening) or treatment, benefit/risk, uncertainty.

Background

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Main Decision Aid Developers

Organisation Country

Ottawa Hospital Research Institute (OHRI)

Patient Decision Aids

Canada

Informed Medical Decisions Foundation

Shared Decision Making Program

USA

Agency for Healthcare Research and Quality

Effective Healthcare Program

USA

Mayo Clinic

Shared Decision Making National Resource Center

USA

The Health Foundation

Person-centred care resource center

UK

Servicio Canario de Salud

Participa y decide sobre tu salud

Spain

Background

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Development process criteria (reports readability levels,

reports update, acceptable to users)

Content criteria (list of options, benefits/advantages,

compares probabilities)

Effectiveness criteria (evidence that it helps people know

about different options…)

Background

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Agency for Healthcare Quality and Assessment of Catalonia

Catalan Patient Advisory Council

Collaboration:

• Patient and family associations

• Scientific Societies

Objective

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• To provide patients with the best scientific evidence through

information (health condition, appropriate treatment options,

test on patients’ values) for discussing with their doctors

reasonable treatment and decision options.

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Results

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• Treatment options

• Pros and cons of each

option

• Life style conditions

• Patient Preference test

• FAQ

Advanced Chronic

kidney disease

Surgery Radiation

BraquitherapyActive surveillance

Peritoneal dyalisis Hemodyalisis

Localized prostate cancer

Transplantation

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Discussion

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•To improve communication between healthcare

professionals and patients

• To make patients less passive in decision making

process

•To reduce overuse

•To improve adherence to the treatment.

Patient Decision Aids may help...

Stacey D et al; Decision aids for people facing health treatment or screening decisions (Review) 2014 The

Cochrane Collaboration.

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Discussion

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• Lack of knowledge about supporting patients

making health decisions

•Time constraints

•Lack of resources

•Training of healthcare professionals

Challenges for the future...

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Conclusions

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Both Decision Aids will help to ensure that patients start being

involved in the treatment decision making with their doctors and

this might have an impact in the future in decreasing overuse or

increasing patient empowerment and satisfaction.

These DAs not only emphasize the availability of multiple

treatment options and the role of the patient in this process but

the added value is that they take into account patients’

preferences, values and opinions.

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Conclusions

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There are however still some challenges to cope with in the

future such as the evaluation of this new DAs and the main

barriers and facilitators to overcome for its successful

implementation in the decision making process.

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Next steps

Healthcare professionals

Scientific societies

Research groups

2015• Breast cancer

• Carpal tunnel

• Knee replacement surgery

• Diabetes

• C-section

• Hip replacement surgery

• Decisions at the end of life

2016

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http://decisionscompartides.gencat.cat

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Montse Moharra

Agency for Healthcare Quality and Assessment of Cataloniammoharra@gencat.cat

http://aquas.gencat.cat

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Shared Decision Making (Decisions Compartides)

is a project of the Catalan Health Ministry of the Generalitat de

Catalunya

More information at: http://decisionscompartides.gencat.cat

© About this presentation. 2015, Generalitat de Catalunya. Departament de Salut. Agència de

Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)

The contents of this presentation are under a Creative Commons license for Attribution-

NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)

The license can be accessed at: http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en