Our expert answers 3 Questions
My research has demonstrated that patients are interested in hearing about treatment options and contributing to decisions about their care, but often face challenges to getting more involved. Patients may not be consciously aware of the individual values system they use to make choices, may have difficulty describing what they care about most, and may only discuss a single treatment option recommended by their healthcare provider. I am interested in finding ways for patients to gain insight into their own goals and values, share that information with their healthcare provider, and actively contribute to their treatment choices through this process.
Many treatment decisions are complex, particularly in scenarios where clinical evidence hasn’t identified a single treatment that is clearly the best option for most patients most of the time. This is particularly true for peripheral artery disease (PAD), where several treatment options are often reasonable but a single “best” choice often isn’t clear based on available evidence. In these situations, understanding how the patient prioritizes trade-offs between treatment-related factors (like risk, durability, and symptomatic improvement) would make it possible to design a personalized strategy based on this information. I see enormous potential for this approach to move healthcare past outdated “one size fits all” approaches based on clinical data alone.
Patient-centered healthcare makes sense from an ethical perspective (as well as a selfish one for anyone in the patient role), but providers face time constraints and efficiency demands that make it challenging (if not impossible) to develop an sense of an individual patient’s social context and values during a clinic visit that may last 15 minutes or less. Novel and efficient approaches for identifying this information and inserting it into the communication process therefore have potential to make patients more active participants in their treatment choices, allowing them an opportunity to opt out of a treatment inconsistent with their values or ask about their options. Beyond satisfaction and engagement, these approaches have potential to improve adherence, increase efficiency of care, and promote trust between patients and providers.