Abstract

Shared Decision-Making in Preventive Activities Abstract. Shared Decision-Making (SDM) is particularly useful in conditions where decisions are preference-sensitive, i.e., where preferences and values of patients are crucial for the further proceeding. This typically applies to conditions where the potential benefit and the potential harm are similar. Preventive activities are characterized by the fact that there is no current burden of disease and the benefit to expect is far in the future. Therefore, it is preference-sensitive if the current effort really pays off. The procedure of SDM in (preventive) counselling can be classified into three steps: Team Talk, Option Talk and Decision Talk. For every step, we present examples of how to talk. After an overview of the current evidence, we present four examples of how to apply SDM in preventive conditions: quit-smoking counselling, lifestyle coaching, vaccination counselling and screening for cancer. Finally, we focus on the role of activated patients and point out the opportunity for SDM during check-up examinations. For all these implementation issues useful tools and links are presented. In summary, important elements of SDM, such as patient centeredness, clarifying needs/goals and shared responsibility, are crucial for the entire spectre of caring for patients, not only for prevention.

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