Participation in medical decision-making: Attitudes of Italians with multiple sclerosis

Giordano, Andrea; Mattarozzi, Katia; Pucci, Eugenio; Leone, Maurizio; Casini, Federica; Collimedaglia, Laura; Solari, Alessandra

doi:10.1016/j.jns.2008.07.026

Cited by 62 publications

(62 citation statements)

References 35 publications

(49 reference statements)

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“…Given that earlier work indicated differences between German and Italian MS patients [42], a European initiative to establish common tools to assess decision-making quality in six European and one Australian centers has recently been funded (Gemeinnützige Hertie Stiftung). The AutoMS study (www.automsproject.org) will revise and migrate the CPS [21], one of the best-established tools for measuring role preferences in decisions about treatment [43], into a self-administered electronic version.…”

Section: Automs -Autonomy Preferences Risk Knowledge and Decision Mamentioning

confidence: 99%

Decisions on multiple sclerosis immunotherapy: New treatment complexities urge patient engagement

Heesen

Solari²,

Giordano³

et al. 2011

Journal of the Neurological Sciences

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Section: Automs -Autonomy Preferences Risk Knowledge and Decision Mamentioning

confidence: 99%

Decisions on multiple sclerosis immunotherapy: New treatment complexities urge patient engagement

Heesen

Solari²,

Giordano³

et al. 2011

Journal of the Neurological Sciences

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“…More studies seeking to shed light on the issues that influence patient engagement in MS are needed. Previously, a collaborative role was found to be preferred by Italian MS patients (who varied in clinical and general characteristics) (Giordano et al, 2008). The patients' cognitive styles and personality traits were not routinely investigated in depth.…”

Section: Discussionmentioning

confidence: 99%

“…These results are collapsed to: "active'' (activeactive or active-collaborative), "collaborative" (collaborative-active or collaborative-passive), or "passive" (passive-collaborative or passive-passive). We used the Italian version of the CPS (Giordano et al, 2008). Disability was assessed using the Expanded Disability Status Scale (EDSS) (Kurtzke, 1983), administered by a trained neurologist, and the number of relapses since clinical onset was recorded.…”

Section: Methodsmentioning

confidence: 99%

Melatonin 4 mg as prophylactic therapy for primary headaches: a pilot study

Bougea¹

2016

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“…It was developed by Degner and Sloan, 42 and it has undergone psychometric testing in different settings and samples. [43][44][45][46] Originally designed as a set of cards, the content has been adapted for written surveys, and the measure has been positively evaluated along several criteria, including appropriateness, face validity, responsiveness, interpretability, precision, acceptability, and feasibility. 40 In the category of measures that assess the decision-making process, we highlight 4 measures.…”

Section: Review Of Key Measurement Instrumentsmentioning

confidence: 99%

Measuring Shared Decision Making

Sepucha

Scholl

2014

Circ: Cardiovascular Quality and Outcomes

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In the past few decades, patient-centeredness has gained in importance, 1,2 and policies to promote patient-centered care have been increasing.3 Several different models of patient-centered care have been described. Although these models vary on their specific definitions and dimensions, they all emphasize the importance of facilitating the engagement of patients in their own healthcare decisions. 1,4,5 In some cases, facilitating patient engagement in decisions focuses on ensuring patients receive proven, effective care and do not receive proven, ineffective care. In cardiology, these situations often correspond to American College of Cardiology/American Heart Association class I or III recommendations with strong evidence, and the quality of decisions can be measured by the percentage of eligible patients who receive care that is consistent with the guidelines. Several quality measures endorsed by the National Quality Forum for cardiovascular care fall into these situations, such as the percentage of patients who receive β-blockers at discharge from cardiac surgery or persistence of β-blocker usage after a heart attack except for those patients at low risk.However, even in situations with class I recommendations, some questions arise in implementing these recommendations into clinical care. For example, the high nonadherence rates for β-blocker therapy (or statin therapy) suggest that patients think differently about the tradeoffs between the potentially modest survival gain and the side effects of the therapy. 6,7 In these cases, is it acceptable for patients to decline therapy, and if so, what if any documentation might we need to be confident that the decision was informed and high quality?As Brindis and Walsh 8 highlight in their presidential address, decisions, such as the use of statins for primary prevention, treatment of atrial fibrillation, valve replacement (eg, the use of tissue or mechanical valves), and use of implantable cardiac defibrillators, are all common ones for which there is not one clear best choice. In these situations, patients and providers need to consider the evidence and preferences of individual patients to select a treatment. Understanding and measuring the quality of decisions when there are multiple appropriate options require more than examining treatment rates.One approach that supports increased patient engagement in medical decision making is the model of shared decision making (SDM). The concept of SDM was first described in the 1980s 9,10 and is an interactive process between patients (and family members) and the healthcare team to ensure that decisions are evidence based and patient centered. The key elements of SDM in the visit include defining and explaining the problem, helping patients (and providers) to recognize that a decision needs to be made, presenting options, discussing the pros and cons (ie, the outcomes in terms of benefits and risks and costs) of each option, eliciting patients' goals and concerns (ie, finding out what matters most to them), discussing the...

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Participation in medical decision-making: Attitudes of Italians with multiple sclerosis

Cited by 62 publications

References 35 publications

Decisions on multiple sclerosis immunotherapy: New treatment complexities urge patient engagement

Decisions on multiple sclerosis immunotherapy: New treatment complexities urge patient engagement

Melatonin 4 mg as prophylactic therapy for primary headaches: a pilot study

Measuring Shared Decision Making

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