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过敏学家的共同决策。

Shared decision making for the allergist.

机构信息

Department of Pediatrics, Medical College of Georgia, Augusta, Georgia.

Allergy, Asthma & Sinus Center, Milwaukee, Wisconsin.

出版信息

Ann Allergy Asthma Immunol. 2019 May;122(5):463-470. doi: 10.1016/j.anai.2018.08.019. Epub 2018 Sep 7.

Abstract

OBJECTIVE

Shared decision making (SDM) is becoming more commonly appreciated and used in medical practice as a way to empower patients who are facing treatment preference-sensitive conditions, such as allergic rhinitis, atopic dermatitis, food allergy, and persistent asthma. The purpose of this review is to educate the allergy health care provider about how SDM works and provide practical advice and allergist-specific SDM resources.

DATA SOURCES

PubMed and online patient decision aid resources.

STUDY SELECTIONS

Studies and reviews relevant to SDM and patient decision aids relevant to the allergy health care provider were selected for discussion.

RESULTS

There are ethical, practical, economic, and psychological imperatives for the implementation of quality SDM, particularly for chronic diseases. Many benefits and barriers of SDM have been identified and models have been developed to encourage implementation of quality SDM. For the allergy health care provider, SDM for asthma has been shown to improve adherence, outcomes, and patient satisfaction with care. Patient decision aids are useful tools for SDM and have recently been developed for allergen immunotherapy, severe asthma, and atopic dermatitis.

CONCLUSION

Effective SDM has been shown to improve adherence and lead to better outcomes. SDM should be universally implemented as a key component of patient-centered health care. Allergy health care providers should work with their patients to reach treatment decisions that align with their values and preferences.

摘要

目的

在面临治疗偏好敏感情况(如过敏性鼻炎、特应性皮炎、食物过敏和持续性哮喘)的患者中,共享决策(SDM)作为一种赋予患者权力的方法,在医学实践中越来越受到重视和应用。本综述旨在教育过敏病医护人员 SDM 的工作原理,并提供实用建议和过敏专科医生的 SDM 资源。

资料来源

PubMed 和在线患者决策辅助资源。

研究选择

选择了与 SDM 相关的研究和综述,以及与过敏病医护人员相关的患者决策辅助资源进行讨论。

结果

实施高质量 SDM 具有伦理、实践、经济和心理方面的必要性,特别是对于慢性病而言。已经确定了 SDM 的许多益处和障碍,并开发了模型来鼓励实施高质量 SDM。对于过敏病医护人员,哮喘的 SDM 已被证明可以提高依从性、改善结局并提高患者对护理的满意度。患者决策辅助工具是 SDM 的有用工具,最近已为过敏原免疫治疗、严重哮喘和特应性皮炎开发。

结论

有效的 SDM 已被证明可以提高依从性并带来更好的结局。SDM 应作为以患者为中心的医疗保健的关键组成部分普遍实施。过敏病医护人员应与患者合作,做出符合其价值观和偏好的治疗决策。

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