Achieving patient-centered care across the spectrum

May 13, 2014

Providing patient-centered care consistently in clinical practice requires practitioners who are able to recognize that different clinical situations require different approaches and are skilled enough to adapt.

Across the range of health-care problems, patient-centered care has been found to be associated with improved patient outcomes, including improved self-management, patient satisfaction, and medication adherence, and some studies have found evidence for improved clinical outcomes. Data from surveys and research indicate that clinicians often do not take ' perspectives into account during the decision-making process. This is because clinicians are often challenged by the diversity of situations that arise.

Dr. Glyn Elwyn of the Dartmouth Center for Health Care Delivery Science is the principal investigator of a study in the current issue of Annals of Family Medicine. Elwyn said that practitioners could use or integrate two methods: shared decision making and when discussing options for treatment with patients.

When patients face tough treatment decisions, shared decision making alone is appropriate. And where clinicians perceive a need to change behavior to improved , motivational interviewing can be used. Many clinical consultations may require elements of both approaches.

"Clearly, different situations require different communication approaches," Elwyn said. "Each situation has different psychosocial, cultural and medical implications."

Shared decision making is a method where clinicians and patients make decisions together using the best available evidence. Patients are encouraged to consider available screening, treatment or management options and the likely benefits and harms of each. It is used to support patients in making decisions where there is more than one reasonable option.

Motivational interviewing is most often applied in situations that usually require some degree of about which a patient feels ambivalent, such as lifestyle choices or adherence to medications. Originally developed for dealing with drug and alcohol addiction, the scope has widened to include how best to motivate behavior change across many domains.

Motivational interviewing recognizes that making behavioral change is difficult and that telling or persuading people to change will often meet with resistance. Clinicians should explore and resolve ambivalence and by doing so elicit and encourage a patient's own motives to change.

For motivational interviewing there is evidence for efficacy in treating addictions and mixed evidence in improving health outcomes of patients with diabetes, asthma, and heart disease.

The researchers acknowledge the challenge of implementing shared and motivational interviewing into routine practice. "We believe, however, that we will see little progress in patient-centered care unless these approaches are valued as core elements of good practice; they should be taught, assessed and integrated into daily practice, then appropriately measured and rewarded."

Explore further: Motivational interviewing can positively impact childhood obesity

More information: To view the abstract in the Annals of Family Medicine, please go to annfammed.org/content/12/3/270.abstract

Related Stories

Motivational interviewing can positively impact childhood obesity

May 4, 2014
Pediatricians and dietitians who used motivational interviewing techniques to counsel families about their young child's weight were successful in reducing children's body mass index (BMI) percentile 3.1 more points than ...

Patient choice at heart of new online decision aids

August 28, 2013
A health website has launched a range of free online health decision aids, allowing patients to make more informed treatment choices, thanks to the work of a Newcastle University academic.

Taking statins to lower cholesterol? New guidelines provide opportunity to discuss options with your doctor

February 4, 2014
Clinicians and patients should use shared decision-making to select individualized treatments based on the new guidelines to prevent cardiovascular disease, according to a commentary by three Mayo Clinic physicians published ...

Ask 3 questions, patients urged

August 26, 2011
Asking three simple questions could help patients have more say and better understand their treatment options, according to University research.

Shared decision making improves patient satisfaction during radiation therapy

April 14, 2014
Taking an active role in their radiation treatment decisions leaves cancer patients feeling more satisfied with their care, and may even relieve psychological distress around the experience, researchers from the Perelman ...

Recommended for you

Across Asia, liver cancer is linked to herbal remedies: study

October 18, 2017
Researchers have uncovered widespread evidence of a link between traditional Chinese herbal remedies and liver cancer across Asia, a study said Wednesday.

Eating better throughout adult years improves physical fitness in old age, suggests study

October 18, 2017
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study led by the University of Southampton.

Global calcium consumption appears low, especially in Asia

October 18, 2017
Daily calcium intake among adults appears to vary quite widely around the world in distinct regional patterns, according to a new systematic review of research data ahead of World Osteoporosis Day on Friday, Oct. 20.

New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017
Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered ...

Experts devise plan to slash unnecessary medical testing

October 17, 2017
Researchers at top hospitals in the U.S. and Canada have developed an ambitious plan to eliminate unnecessary medical testing, with the goal of reducing medical bills while improving patient outcomes, safety and satisfaction.

No evidence that widely marketed technique to treat leaky bladder/prolapse works

October 16, 2017
There is no scientific evidence that a workout widely marketed to manage the symptoms of a leaky bladder and/or womb prolapse actually works, conclude experts in an editorial published online in the British Journal of Sports ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.