Transcript
Announcer:
You’re listening to Living Rheum on ReachMD. On this episode, we’ll hear from Dr. Elena Myasoedova, who will be discussing shared decision-making in rheumatoid arthritis care. Dr. Myasoedova is a Professor of Medicine at the Mayo Clinic College of Medicine and Science in Rochester, Minnesota. Here she is now.
Dr. Myasoedova:
Shared decision-making helps us to choose not just effective treatment, but what a patient is comfortable with and can realistically sustain. There's a lot that goes into shared decision-making, of course. Medications differ by route, frequency of use, risks, monitoring costs, and how well they fit a patient’s life.
So I try to keep it simple. I explain what we are trying to achieve, usually remission or low disease activity and the prevention of joint damage. And then compare a few realistic options. We discuss the expected benefits, important risks, route and frequency of medication use, monitoring, schedule, and practical issues such as cost and times when the patient needs to come to clinic. Then I ask which of those differences matter most to the patient, and we make a choice.
There are patients who are, for example, needle adverse, who can be good candidates for pill options, with the targeted treatments that we have for rheumatoid arthritis. There are patients who prefer infusions over injections, as they feel safer when treatments are delivered in a medical setting. There are patients who don't want to go to an infusion center and want to stay home to receive their treatments. Even these logistics define what's done and what's chosen to manage this particular patient.
My strategy is to identify the patient's main priority early in the visit and focus the discussion on the decisions that actually need to be made that day. And then this focused conversation can be really collaborative without being long. So identify one point that you want to discuss today, and go for it. Get the patient to provide their feedback, and come up with a shared decision.
Announcer:
That was Dr. Elena Myasoedova talking about how to implement shared decision-making in rheumatoid arthritis care. To access this and other episodes in our series, visit Living Rheum on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
