Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Ann Allergy Asthma Immunol. 2020 Sep;125(3):252-261. doi: 10.1016/j.anai.2020.01.029. Epub 2020 Feb 7.
To review risk communication in the context of shared decision making.
Articles describing risk communication, shared decision making, and cost-effective healthcare delivery.
A narrative review detailing approaches to improve risk communication and shared decision making to optimize patient-centered cost-effective practice.
Risk communication must occur on a foundation of mutual trust and can be improved by keeping risk in perspective of everyday hazards, such as using pictograms when possible, providing numeric likelihoods of risks and benefits, and discussing absolute risks. Variability in patient-perceived quality of life for allergic and nonallergic health states may affect the health and economic outcomes of many allergy therapies. Shared decision making improves patient knowledge and risk perception, engagement, and adherence. Patient decision aids can be time-consuming to develop and validate, but their use is associated with a more accurate understanding of patient-oriented outcomes.
Communicating risk is complex, and validated patient decision aids using visual aids, presenting essential information, using knowledge checks, and incorporating values clarification can reduce decisional conflict and improve decisional self-efficacy.
回顾在共同决策背景下的风险沟通。
描述风险沟通、共同决策和具有成本效益的医疗保健提供的文章。
详细描述改善风险沟通和共同决策以优化以患者为中心的具有成本效益的实践方法的叙述性评论。
风险沟通必须建立在相互信任的基础上，并可以通过将风险与日常危险保持在适当的视角来改善，例如在可能的情况下使用象形图，提供风险和收益的数值可能性，并讨论绝对风险。过敏和非过敏健康状况的患者感知生活质量的变异性可能会影响许多过敏治疗的健康和经济结果。共同决策可以提高患者的知识和风险感知、参与度和依从性。患者决策辅助工具的开发和验证可能很耗时，但使用它们与更准确地了解以患者为导向的结果相关。
沟通风险是复杂的，使用视觉辅助工具、呈现基本信息、使用知识检查和纳入价值观澄清的经过验证的患者决策辅助工具可以减少决策冲突并提高决策自我效能感。
