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Shared decision-making in primary care: Tailoring the Charles et al. model to fit the context of general practice

Murray, E; Charles, C; Gafni, A; (2006) Shared decision-making in primary care: Tailoring the Charles et al. model to fit the context of general practice. PATIENT EDUC COUNS , 62 (2) 205 - 211. 10.1016/j.pec.2005.07.003.

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Abstract

Objective: To explore the application of the original Charles et al. model of shared treatment decision-making [Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med 1997;44:681-92; Charles C, Gafm A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med 1999;49:651-61] in the context of general practice, and to determine whether the model needs tailoring for use in this clinical context.Methods: Conceptual paper, presenting the defining characteristics of general practice compared to the original clinical context for which the model was developed (i.e. life threatening disease with different treatment options), and exploring how the model can be tailored for use in the context of general practice.Results: We identify two areas where the original model requires tailoring: sharing the decision-making around agreeing on an agenda for each consultation; and adapting the information transfer component of the model to acknowledge that doctors may not be the only, or even the main, source of technical information for patients. Finally, we explore the importance of shared decision-making in the context of chronic disease.Conclusion: The Charles et al. model can be tailored for use in general practice. Practice implications: Tailoring the model for use in general practice has implications for research, in terms of identifying the additional physician competencies needed for implementation. Policy makers who wish to promote shared decision-making need to ensure that incentives which prioritize access and health outcomes do not militate against shared decision-making in general practice. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Type: Article
Title: Shared decision-making in primary care: Tailoring the Charles et al. model to fit the context of general practice
DOI: 10.1016/j.pec.2005.07.003
Keywords: physician-patient relations, shared decision-making, primary health care, HEALTH-CARE, PARTICIPATION, EXPECTATIONS, ENCOUNTER, OUTCOMES, QUALITY
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/118105
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