Patient Preferences and Decision-Making
A past case I encountered was that of a patient diagnosed with major depression disorder. Before coming for a consultation, John (pseudonym) had researched the condition and available treatment modalities. John insisted that the treatment plan should include both medication and cognitive-behavioral therapy. The patient had socioeconomic challenges and a history of substance use. Initially, the primary focus of the treatment plan was medications, which did not fully include John’s preferences. As a result of not addressing the patient’s preference in the treatment plan, the patient had a slower recovery process and did not fully comply with the treatment plan. Also, social determinants, which are economic instability and insufficient social support, impacted the ability of the patient to consistently follow up with therapy and adhere to the medication prescribed.
The patient decision aid that I selected was Depression in Older Adults: Choosing and Option to Improve Mood. This decision tool, just like others, is used to enable shared decision-making and offer support to patients to make informed choices (Alarcon-Ruiz et al., 2020). If it were used in the case scenario encountered, it would describe the disorder and the harms and benefits of every treatment approach. This decision tool can help enhance patient education, patient-clinician communication, and decisional conflict (Sedláková et al., 2023).
In my professional practice, I plan to use this decision-aid inventory to enable discussions with patients about their treatment options. This method can help ensure that treatment plans incorporate the values and preferences of patients, ultimately improving patient satisfaction and outcomes. Furthermore, according to Barr et al. (2019), decision aids have a positive impact because they increase treatment and ultimately result in higher clinical improvement. This is among my personal career goals that I am hopeful to achieve.
References
Alarcon-Ruiz, C. A., Zafra-Tanaka, J. H., Diaz-Barrera, M. E., Becerra-Chauca, N., Toro-Huamanchumo, C. J., Pacheco-Mendoza, J., Taype-Rondan, A., & De La Cruz-Vargas, J. A. (2020). Effects of decision aids for depression treatment in adults: systematic review. BJPsych Bulletin, 1–10. https://doi.org/10.1192/bjb.2020.130
Barr, P. M., Forcino, R. C., Dannenberg, M. D., Mishra, M., Turner, E. H., Yaara Zisman-Ilani, Matthews, J., Hinn, M., Bruce, M. L., & Elwyn, G. (2019). Healthcare Options for People Experiencing Depression (HOPE*D): The development and pilot testing of an encounter-based decision aid for use in primary care. BMJ Open, 9(4), e025375–e025375. https://doi.org/10.1136/bmjopen-2018-025375
Sedlakova, J., Westermair, A. L., Biller-Andorno, N., Meier, C. A., & Trachsel, M. (2023). Comparison of analog and digital patient decision aids for the treatment of depression: A scoping review. Frontiers in Digital Health, 5. https://doi.org/10.3389/fdgth.2023.1208889
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Question 
To Prepare:
• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/Links to an external site
Patient Preferences and Decision-Making
o Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
• After you have chosen a topic (or condition) and a decision aid, consider social determinants of healthLinks to an external site. were considered in the treatment plan Social determinants of health can affect a patient’s decision as these are conditions in the patient’s environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context.
• NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.
POST: a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of health links to an external site., and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision-making, both in general and in the experience you described. Describe how you might use this decision-aid inventory in your professional practice or personal life.
(Please Note: The underlined “social determinants of health” in the above content is meant to hotlink to the following Walden webpage and content:
Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden Links to an external site.University)
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