Article
Shared decisions making on an evidence based framework
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Published: | July 10, 2012 |
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Outline
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Background: When developing Physiotherapy guidelines and/or statements one focuses on description of proven effective physiotherapy fitting to the needs of patients. However, research shows that therapists find it hard to make appropriate choices in the clinical reasoning process, predominantly as a result of the overload of outcome measures advised in the guidelines and to implement shared decision-making, especially in case of comorbidity. Additionally, following the guidelines does not ensure adequate patient therapy adherence and optimal health outcomes. Therefore, active involvement of patients in goal setting and intervention decisions is needed to increase adherence and healthcare outcomes.
Objective: To develop a three dimension model which can be used as an algorithm for shared decision-making based on scientific evidence.
Methods: A Delphi method was used with stakeholders (patients, physiotherapists, researchers) to develop a framework in which guidelines can be organized.
Results: A consensus based three dimensional framework was constructed which serves the therapist in choosing a tailor made guide for shared decision-making. In general it was noted that the use of the framework may only work when compatible ICT-solutions are developed to support implementation.
Discussion and Implications for guideline developers/users: At the congress the framework and a prototype of the ICT-solution will be presented. Further research is needed to study the effect of the framework on the implementation of guidelines.