Another aspect of shared decision making is realizing when a treatment change is needed. For example, Dr. Desai’s group is now collecting patients’ scores on RAPID3 (Routine Assessment of Patient Index Data 3) via tablet computers in the waiting room to measure rheumatoid arthritis disease activity. The RAPID3 score is automatically uploaded into the medical record and can be used during the office visit to show patients how their rheumatoid arthritis is responding to treatment over time. This can aid patients and providers to make shared decisions over medication changes.
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“I think medicine has evolved to where you really want the patient to be an equal partner in the decision making around medications,” Dr. Desai concludes. Unfortunately, practicalities, such as time, continue to pose barriers to implementing shared decision making in many clinical settings. But increased awareness and willingness on the part of physicians to embrace shared decision making is likely to help. More patients may want to participate in shared decision making than providers realize—they just need the encouragement and guidance to do so.
Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.
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