Quality statement 1: Shared decision‑making
Quality statement
People are given the opportunity to be involved in making decisions about their medicines.
Rationale
Clinical outcomes and patient satisfaction are likely to be better when decisions about medicines are made jointly between the person taking the medicine and the prescriber (shared decision‑making). A person's preferences and how they value treatment options and outcomes should be taken into account. People also need to have enough information to make informed choices. Patient decision aids can be used to support shared decision‑making. Choices may include decisions not to take specific medicines.
Quality measures
Structure
a) Evidence that prescribers give people information about the potential benefits and harms of using medicines.
Data source: Local data collection.
b) Evidence that prescribers take into account people's preferences and values about treatment options that includes the use of medicines.
Data source: Local data collection.
c) Evidence that prescribers offer people the opportunity to use available decision aids to make informed choices about the use of medicines that take account of the trade‑off between potential benefits and harms.
Data source: Local data collection.
Outcome
a) Medicines adherence.
Data source: Local data collection.
b) Patient satisfaction with outcomes from the use of medicines.
Data source: Local data collection.
What the quality statement means for service providers, healthcare professionals and commissioners
Service providers (such as primary and secondary care and pharmacy services) ensure that people are given the opportunity to be involved in making decisions about their medicines in partnership with professionals who prescribe medicines.
Healthcare professionals (such as prescribers and community pharmacists) ensure that people are given the opportunity to be involved in making decisions about their medicines. For example, healthcare professionals can use patient decision aids to support shared decision‑making and they should ensure that people who take medicines have information about the potential benefits and harms.
Commissioners (such as clinical commissioning groups and NHS England) ensure they commission services in which people are given the opportunity to be involved in making decisions about their medicines in partnership with professionals who prescribe medicines.
What the quality statement means for patients, service users and carers
People
who are considering whether or not to take a medicine are given the opportunity to be involved in making the decision with their healthcare professional. The decision should be in line with the person's preferences and what they consider is important, and should take into account information about the potential benefits and harms of the medicine.
Definitions of terms used in this quality statement
Involved in making decisions
Patients should have the opportunity to make informed decisions about their medicines, in partnership with their healthcare professionals. Healthcare professionals should take account of a person's values and preferences by discussing what is important to them about treating or managing their condition(s) and their medicines. They should ask open questions to understand the person's ideas, concerns and expectations. This process can he helped by using patient decision aids. The person's values and preferences about treatment options may be different from those of the healthcare professional, and making assumptions about these should be avoided. [NICE's guideline on medicines optimisation, recommendation 1.6.2 and full guideline]
Equality and diversity considerations
People who are offered or prescribed medicines may have different values and preferences to those of their healthcare professional, and these values and preferences may affect their choices about medicines. Healthcare professionals should be sensitive and supportive to ensure that everyone can express their preferences about the use of medicines and take part in shared decision‑making. Healthcare professionals should take into account that some people may need additional support in communicating their preferences or in understanding the information given to them. This might be, for example, because English is not their first language or they have communication or sensory difficulties.