Parkinson's Decision Aid
Introduction
It is increasingly recognized that patients are more likely to get the most benefit from medicines and achieve better health outcomes if they play an active role in decision-making about their own care. This requires greater discussion between professionals and patients about treatments and
an expectation on the part of patients that they will be involved in decision-making.
However, this can be difficult for patients, particularly when the outcomes of treatment are uncertain or when the options available to them have benefit and harm profiles that they value differently.
Patient decision aids are new resources which can help patients participate in decisions about their health care in such situations.
Need
A recent Cochrane review concluded that decision aids improve knowledge and realistic expectations, enhance active participation in decision-making without increasing anxiety, lower decisional conflict, decrease the proportion of people remaining undecided, and improve agreement between values and
choice.
Patient decision aids can take a range of formats, from basic booklets containing patient worksheets, fact sheets through to interactive websites
However, they usually have some common content areas: background on the disease, information about the different options available and probabilities of different outcomes, space for the user to clarify their own values and preferences, accounts of the experiences of others, and guidance on
weighing the options and discussing the resulting preferences during a consultation with a professional.
A Parkinson's Decision Aid
The decision on drug management is a difficult one from the patient perspective, and the different options in terms of management with levodopa vs. dopamine agonists are characterised by different probable short and long term outcomes, which patients may value differently.
Furthermore, at the time of diagnosis, patients are faced with a vast array of information to take in at the same time as taking in the shock of the news.
It is likely that they would value highly a tool which brings together in one place the evidence which they need to assist them to make an informed choice with a health professional about their treatment plan.
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