Essential elements of shared decision-making
| 1 Define the problem How is the pain affecting the patient’s quality of life and ability to function? |
| 2 Present and discuss treatment options Consider nonpharmacologic (eg, physical therapy), pharmacologic, and procedural options |
| 3 Discuss benefits, risks, and costs Consider efficacy, adverse effects, availability, monitoring needs, and other risks |
| 4 Explore the patient’s values and preferences Discuss ideas, concerns, and outcome expectations |
| 5 Discuss the physician’s treatment recommendations Base recommendations on medical knowledge and patient preferences |
| 6 Discuss the patient’s ability to follow through on the treatment plan Can the patient realistically adhere to appointments, tests, and referral plans? |
| 7 Clarify understanding Consider the patient’s health literacy and assess the patient’s understanding of options |
| 8 Make or defer decision Make a treatment plan or delay until additional input (eg, from family) can be gathered |
| 9 Arrange follow-up Create a plan to follow up and modify or continue the treatment decision |