Shared decision making in mental health: prospects for personalized medicine
- PMID: 20135903
- PMCID: PMC3181931
- DOI: 10.31887/DCNS.2009.11.4/redrake
Shared decision making in mental health: prospects for personalized medicine
Abstract
This paper describes the shared decision-making model, reviews its current status in the mental health field, and discusses its potential impact on personalized medicine. Shared decision making denotes a structured process that encourages full participation by patient and provider. Current research shows that shared decision making can improve the participation of mental health patients and the quality of decisions in terms of knowledge and values. The impact of shared decision making on adherence, illness self-management, and health outcomes remains to be studied. Implementing shared decision making broadly will require re-engineering the flow of clinical care in routine practice settings and much greater use of information technology. Similar changes will be needed to combine genomic and other biological data with patients' values and preferences and with clinicians' expertise. The future of personalized medicine is clearly linked with our ability to create the infrastructure and cultural receptivity to these changes.
Este artículo describe el modelo de la toma de decisiones compartidas, revisa su situación actual en el campo de la salud mental y discute su potencial impacto en la medicina personalizada. La toma de decisiones compartidas traduce un proceso estructurado que fomenta la participación total del paciente y del proveedor, La investigación actual muestra que la toma de decisiones compartidas puede mejorar la participación de los pacientes mentales y la calidad de las decisiones en términos del conocimiento y los valores. Se debe estudiar el impacto de la toma de decisiones compartidas en la adherencia, el auto manejo de la enfermedad y las consecuencias en la salud. La implementación de la toma de decisiones compartidas en líneas generales requerirá de una reingeniería del circuito de la atención clínica en los ambientes de práctica cotidiana y un mayor empleo de la tecnología de la información. Se necesitarán cambios similares para combinar datos genómicosy otros datos biológicos con los valores y preferencias de los pacientes, y con la experiencia de los clínicos. El futuro de la medicina personalizada está claramente relacionado con nuestra capacidad de crear la infraestructura y la receptividad cultural a estos cambios.
Cet article décrit le modèle de prise de décision partagée, le resitue dans le cadre actuel de la santé mentale et analyse son influence potentielle dans la médecine personnalisée, La prise de décision partagée est un processus structuré qui encourage la participation entière du patient et du médecin, La recherche actuelle montre que cette prise de décision peut favoriser la participation des patients psychiatriques et la qualité des décisions en termes de connaissances et de valeurs. Il faut en étudier l'influence sur l'adhésion au traitement, la prise en charge individuelle de la maladie par le patient et l'évolution de son état de santé, La mise en oeuvre étendue de cette prise de décision partagée nécessitera de réorganiser les soins cliniques dans le cadre d'une pratique de routine et d'utiliser de manière plus importante les technologies de l'information. Associer la génomique et les autres données biologiques avec les préférences des patients et l'expérience des médecins demandera également des changements. L'avenir de la médecine personnalisée dépend clairement de notre capacité à créer l'infrastructure et la réceptivité culturelle à ces changements.
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