There was an interesting talk about shared decision-making for kidney cancer patients at the European Association of Urology (EAU) Annual Meeting earlier this week. There are many treatment options for people with kidney cancer. Decisions about treatment options can be made by the healthcare professional only (paternalistic decision-making), the healthcare professional and patient together (shared decision-making), or the patient using information from the healthcare professional (informed decision-making).
Traditionally, the healthcare professional made the decision about treatment using evidence-based research. Shared decision-making is a joint process in which the healthcare professional works together with the patient to reach a decision about care. It involves choosing tests and treatments based both on evidence and on the patient’s individual preferences, beliefs, and values. It makes sure the patient understands the risks, benefits, and possible consequences of different options through sharing information and discussion.
The process of shared decision-making involves:
- Seeking the patient’s participation
- Helping the patient explore and compare treatment options
- Assessing the patient’s values and preferences
- Reaching a decision with the patient
- Evaluating the patient’s decision.
The benefits of using decision aids for shared decision-making were discussed. Decision aids contain easy to understand and relevant information about the patient’s diagnosis. They highlight the pros and cons of each treatment option. They also contain questions that give patients a better idea of preferences and values.
The International Kidney Cancer Coalition (IKCC) has produced a series of ‘My treatment, my choice’ shared decision aids for small renal masses, locally advanced kidney cancer and metastatic kidney cancer, and is currently working on a decision aid for clinical trials. They can be found on the IKCC website here.
Shared decision-making is very helpful in many ways to improve the quality of care. It is an important part of empowering patients to make decisions about their own care and treatment.