Faculty of Health and Medical Sciences

Apply the evidence

Consider the point of view of your patient

A patient with her practitioner




Health professionals can make recommendations in line with the evidence, but patients also have views on their healthcare which affect their choices and compliance. Failure to consider the patient’s viewpoint may compromise treatment as well as relationships.






Values

  • Consider if your patient is likely to be compliant with the treatment and the ideal duration of the treatment.
  • Assess whether your patient will attend investigations needed to monitor a treatment response.
    • Discuss and negotiate follow-up requirements for treatment or investigations.

Preferences

  • Patient buy-in is much more likely if they have a clear picture of the risks and benefits as they apply to them. This is particularly true for interventions where the benefits are not immediately obvious to the patient, such as treatment of hypertension, hypercholesterolemia, or adjuvant chemotherapy for resected cancers.
  • Different patients may place a different weight on the importance of future illness versus current costs and toxicities, and may trade-off one against the other in different ways.
  • Remember that patients’ preferences may be different from those of health care professionals. Discordant preferences do not mean the clinician is right and the patient is wrong. Declining treatment does not always mean that the patient does not fully understand the risks and benefits of a clinical option.

Example of research on patient preferences.

Alternatives

  • Determine whether an alternative intervention or test would be more appropriate or acceptable for your patient.
  • Does another intervention have a different toxicity profile that would be safer or fit better with your patient’s values and preferences?
  • Consider whether your patient would implement lifestyle changes instead of medication.
  • Ask yourself if doing nothing is an option in your patient.

Outcomes

  • Consider whether the outcomes are appropriate for your patient.
  • Ask yourself or your patient if the outcomes matter to him/her.
    • Enough to take lifelong treatment? Injections? Therapy with significant short or long term toxicities?
  • Assess if your patient is willing to have an invasive test or procedure.
  • Reflect on whether your patient would proceed with further treatment or testing if the result of the test you are considering was positive/negative.