Use of a shared decision-making tool can help foster better understanding and communication and is an “important process to go through with the family,” he says.
PR-COIN (Pediatric Rheumatology Care & Outcomes Improvement Network), a learning network established in 2011 to foster collaboration among pediatrics centers and improve the outcome for patients and families with JIA, has developed the Arthritis Medication Choice Cards that can be downloaded and used in any office setting. The cards are designed to focus the conversation, with the family members and the patient deciding which topic to discuss first, second, third and so on.
Each card is a different topic related to medication choices, including how often different medications are given, potential side effects, how quickly medications have an effect, the cost and stopping the medications.
Research published in Pediatric Rheumatology in 2013 led to development of the decision-making cards for PR-COIN.1 The researchers found that clinicians use a variety of methods to inform families about therapy options and tailor the information according to what they perceive to be the family’s information needs, level of comprehension or mood. Because clinicians are concerned about overwhelming parents with too much information, many parents of children being treated for JIA “are left with persistent questions, information needs, long-lasting concerns and worry about treatment adverse effects.”
“When you sit down and talk about treatments using the shared decision-making tool, all the information is discussed, and together you make a decision. The families feel more engaged. When I use the decision-making cards, I find that the family is much more comfortable at the end of the conversation,” Dr. Laxer says.
Reference
- Lipstein EA, Brinkman WB, Sage J, et al. Understanding treatment decision making in juvenile idiopathic arthritis: A qualitative assessment. Pediatr Rheumatol Online J. 2013 Sep 30;11(1):34.
