Patient engagement and shared decision-making: What do they look like in neurology practice?
Neurology is inherently patient-centered given that clinical uncertainty is common, forcing physicians, patients, and families to partner on treatment approach. An increasing emphasis on patient-centered care, patient engagement, and shared decision-making (SDM) in health care provides neurologists with an opportunity to reassess current clinical approaches to decision-making. Such assessment is not simply theoretical but has clear practice implications, with patients indicating a desire for SDM and calls for reimbursement to be tied to demonstration of SDM in practice. We present a framework for how neurologists enhance patient-centered practice by (1) eliciting patients' values and goals, (2) targeting discussion of clinical options to those values and goals, and (3) partnering with patients to make individualized decisions. We also highlight resources that facilitate SDM and examples of SDM in neurology clinical practice.
Department of Neurology (MJA), University of Florida College of Medicine, Gainesville; Department of Neurology (LMS), University of Maryland School of Medicine, Baltimore; and Pharmaceutical Health Services Research Department (JV, CDM), University of Maryland School of Pharmacy, Baltimore.
Melissa J
MJ
Armstrong
Department of Neurology (MJA), University of Florida College of Medicine, Gainesville; Department of Neurology (LMS), University of Maryland School of Medicine, Baltimore; and Pharmaceutical Health Services Research Department (JV, CDM), University of Maryland School of Pharmacy, Baltimore.
Lisa M
LM
Shulman
Department of Neurology (MJA), University of Florida College of Medicine, Gainesville; Department of Neurology (LMS), University of Maryland School of Medicine, Baltimore; and Pharmaceutical Health Services Research Department (JV, CDM), University of Maryland School of Pharmacy, Baltimore.
Joseph
J
Vandigo
Department of Neurology (MJA), University of Florida College of Medicine, Gainesville; Department of Neurology (LMS), University of Maryland School of Medicine, Baltimore; and Pharmaceutical Health Services Research Department (JV, CDM), University of Maryland School of Pharmacy, Baltimore.
C Daniel
CD
Mullins