Shared Medical Decision Making in Patients with Osteoarthritis of the Hip and Knee

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Kevin J. Bozic, MD, MBA; Jeffrey Belkora, PhD; Vanessa Chan, MPH; Jiwon Youm, BS, MS; Tianzan Zhou, BS;, John Dupaix, MD; Angela Nava Bye, MA, ATC; Clarence Braddock, III, MD, MPH, FACP; Kate Chenok, MBA; James Huddleston III, MD

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Shared Medical Decision Making in Patients with Osteoarthritis of the Hip and Knee

  1. 1. Shared Medical Decision Making in Patients with Osteoarthritis of the Hip and Knee Kevin J. Bozic, MD, MBA1,2, Jeffrey Belkora, PhD2, Vanessa Chan, MPH 1,2, Jiwon Youm, BS, MS3, Tianzan Zhou, BS5, John Dupaix, MD6, Angela Nava Bye, MA, ATC4, Clarence Braddock, III, MD, MPH, FACP8, Kate Chenok, MBA7, James Huddleston III, MD4 1University of California, San Francisco, Department of Orthopaedic Surgery 2University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies 3University of California, San Francisco, School of Medicine 4Stanford University, Department of Orthopaedic Surgery 5University of California, San Diego, School of Medicine 6University of Hawaii, Department of Orthopaedic Surgery 7Pacific Business Group on Health 8Stanford University, School of MedicineWHAT IS SHARED DECISION MAKING (SDM)? Shared Decision Making (SDM) In SDM process both physician and •Incorporates patient preferences and values into decision patient make necessary making contributions to the dialogue. •Useful for„preference sensitive care‟ • No clear„best‟treatment option •Goal: improve decision quality, reduce unwarranted variation Physician providers expert clinical Patient contributes personal input knowledge of conditions, of their tolerance for risk, treatment options and associated preferences for lifestyle, and risks, benefits + limitations of guiding values. evidence.SHARED DECISION MAKING TOOLS• Decision aids (DVD/booklets) • Disease, treatment alternatives• Communication aids (prompt sheets, health coaches) • Develop questions (Question listing)• Questionnaires • Assess knowledge, health related values, preference, decision statusWHAT ARE THE POTENTIAL BENEFITS OF SHARED DECISION MAKING?• More informed patients• More satisfied patients• Increased efficiency of office visits • More appropriate utilization of resourcesPATIENT REACTIONS TO SHARED DECISION MAKING:•“Great to refresh memories and helpful for future doctors.”•“Complete and detailed, very informative”•“Decision and consultation service was fantastic. Made me feel so well-prepared. This is how medicine should work.”•“Having the booklet info available online was terrific. This was exactly the material (statistics) I was looking for all over the web, buthaving a hard time finding in a consolidated format that made sense.”•“The consultation with doctor was superb.”•“Everything was very proactive."

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