Where are the patients in decision-making about their own care?

The policy issue: patient engagement

Occasionally, all citizens have to make important health decisions that affect health outcomes. Strategies to support patient education and engagement should therefore be a fundamental plank of health policy. Also, patients can play an important role in understanding the causes of illness, protecting their health and taking appropriate action, choosing appropriate treatments for acute episodes of ill health, and managing chronic illness. These roles must be recognized and supported.

Policy options

Strategies for promoting an active role for patients should pay attention to health literacy, shared decision-making and self-management. A number of interventions have been shown to be effective in building health literacy, promoting patient involvement in treatment decisions and educating patients to play an active role in self-management of chronic conditions. These interventions include:

• written information that supplements clinical consultations
• web sites and other electronic information sources
• personalized computer-based information and virtual support
• training for health professionals in communication skills
• coaching and question prompts for patients
• decision aids for patients
• self-management education programmes.

Implementation

Governments, health authorities or payers looking for ways to inform and empower patients need to agree about clear goals and a coherent strategy, with actions targeted at the national, regional and organizational levels.