Background and context
Information is collected about the condition, such as prognosis, possible diagnoses, likely impact on the person and supporting organisations.
The appropriate treatment, investigation and goals are identified in line with the person's needs and what matters to them. The person and their healthcare professional work together to consider all the options and alternatives, and the risks, benefits and consequences of these choices.
A preference-based choice is made from the available options, then there is a formal agreement about the treatment, procedure, investigation or test. There is also an agreement about how medicines are administered. The decision is recorded and shared with the person.
Steps 2 and 3 are repeated, as necessary.
Patient decision aids (PDAs) are designed to:
Help people decide on healthcare options by providing evidence-based information on the available options, likely outcomes, benefits, harms and uncertainties.
Support and prepare people to make informed decisions with their healthcare professional. PDAs do not advise people to choose one option over another and are not meant to replace a conversation with a healthcare professional.
Support health professionals to adopt a shared decision‑making approach in a consultation, to ensure that patients, and their family members or carers where appropriate, can make informed choices consistent with the person's values and preferences.
This framework is designed to help people to identify good quality PDAs to aid that process, and to support the development of these.
For the purposes of this framework we have used the definition of decision aids in a 2017 Cochrane Review. It states that people can use PDAs when there is more than one option and neither is clearly better, or when options have benefits and harms that people value differently. They state the decision, describe the options, and help people think about the options from a personal view (for example, how important are possible benefits and harms).
Patient decision aids may vary in length and detail, and may be used before, during, or after a person has spoken to a healthcare professional. They may be intended for the person to read for themselves, to support healthcare professionals during a consultation conversation using standardised, evidence-based information, or for the person and healthcare professional to work through together.
This definition includes any PDAs that:
have a clear decision that needs to be considered
provide evidence‐based information about a health condition, the options, associated benefits, harms, probabilities, and uncertainties
help people to recognise the value of the decision and to help support the value they place on the benefits and harms.
Every person should have basic information about their condition, treatment and care so that they can engage in and manage their health. Some information is only designed to inform the person rather than to aid decision making.
The information people need for shared decision making (of which PDAs are a part) is the same as needed for informed consent. This framework doesn't cover the consent process, although PDAs are sometimes helpful in supporting this process. For further information about obtaining informed consent, see advice from the General Medical Council (GMC) or another relevant professional body.