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Patient decision aids – a tool for shared decision-making

The 2010 NHS White Paper Equity and Excellence: Liberating the NHS proposed that the principle of ‘shared decision-making’ would become the norm so that patients could routinely participate in choices over their healthcare. In order to make decisions, both doctors and patients need information. Clinicians can draw on evidence-based guidelines, trials, books and personal experience, but not all these resources are suitable for the public and the constraints of a standard consultation can make explanations challenging. Traditionally, patient education materials have been used to describe diagnoses and treatments. However, some situations require patients to deliberate carefully on a range of different therapies, all of which carry risks and benefits. For these cases there are now specially designed ‘decision aids’ that assist patients to consider the options and come to an agreed plan with their doctor. Although widely available, these tools are not routinely used in clinical practice. The aims of this paper are to explain the ideas behind decision aids, how they may be used and where to access them. We will also review the evidence for their effectiveness and discuss challenges to incorporating them in consultations.