Patients need to be more involved in care decisions

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Patients need to be more involved in care decisions

Annabel Ferriman BMJ

Patients need to be more involved in decisions about their health care, a new publication from the Institute for Public Policy Research said last week.

Research from the Picker Institute Europe, which was used in the compilation of the report, showed that more patients in the United Kingdom felt excluded from such decision making than elsewhere in Europe and the United States (see graph).

The report, some of whose findings were published in the BMJ last week (30 June, p 1564), said that several changes were needed to develop a more equal partnership between professionals and patients:

· Paternalistic attitudes had to stop

· Professionals’ communication skills had to improve

· Professionals needed training in the special skills required to ensure a shared decision making approach

· Patients needed decision aids that provided information about treatment options and outcomes relevant to their own health status; such aids were available as interactive videos, computer programmes and audiotapes, and printed materials.

"One mechanism for encouraging a more equal relationship between patients and professionals would be to involve patients in professionals’ training throughout their careers," the report added.

Projects are already being developed to explore how this might be put into practice in Lewisham, south London, whereby professionals are educated about the patients’ perspective in, for example, cardiac care and mental health. Age Concern is also working with local NHS trusts to train staff to communicate more effectively the highly sensitive issues around resuscitation with older patients and their relatives and carers.

The report also showed that many members of the public thought that genetic medicine "messes with nature" and were opposed to genetic testing for specific disease (30 June, p 1564).

The Future Patient, by Liz Kendall, is available from the Institute for Public Policy Research, 30-32 Southampton Street, London WC2E 7RA.

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Patients need to be more involved in care decisions

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