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. 2014 May-Jun;12(3):270-5.
doi: 10.1370/afm.1615.

Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems

Glyn Elwyn  1 , Christine Dehlendorf, Ronald M Epstein, Katy Marrin, James White, Dominick L Frosch
Affiliations

Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems

Glyn Elwyn et al. Ann Fam Med. 2014 May-Jun.

Erratum in

  • Ann Fam Med. 2014 Jul-Aug;12(4):301

Abstract

Patient-centered care requires different approaches depending on the clinical situation. Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient's preferences. Many clinical consultations may require elements of both approaches, however. This article describes these 2 approaches-one to address ambivalence to medically indicated behavior change and the other to support patients in making health care decisions in cases where there is more than one reasonable option-and discusses how clinicians can draw on these approaches alone and in combination to achieve patient-centered care across the range of health care problems.

Keywords: concept formation; decision making, shared; motivational interviewing; nondirective therapy; problem solving.

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Figures

Figure 1
Figure 1
Shared decision making. Adapted, with permission, from Elwyn et al and Mulley et al. Notes: team talk = explain need to consider options, ensure patient feels part of a team, ie, not abandoned to make decision on own. Option talk = describe options, pros and cons. Decision talk = explore what matters most and help patients form preferences.
Figure 2
Figure 2
Motivational interviewing. Notes: engaging = building of a helpful relationship; focusing = developing specific direction about change; evoking = eliciting the patient’s own motivations for change; planning = developing commitment to change, formulating a concrete plan of action.
Figure 3
Figure 3
The relationship of shared decision making and motivational interviewing.”
Figure 4
Figure 4
Bill is overweight and having trouble with his diabetes.
See this image and copyright information in PMC

References

    1. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001 - PubMed
    1. Robinson JH, Callister LC, Berry JA, Dearing KA. Patient-centered care and adherence: definitions and applications to improve outcomes. J Am Acad Nurse Pract. 2008;20(12):600–607 http://www.ncbi.nlm.nih.gov/pubmed/19120591 Accessed May 22, 2013 - PubMed
    1. Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2012. http://mcr.sagepub.com/content/early/2012/11/18/1077558712465774.abstract Accessed Jun 15, 2013 - PubMed
    1. Braddock CH, III, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 1999;282(24):2313–2320 - PubMed
    1. Dellasega C, Añel-Tiangco RM, Gabbay RA. How patients with type 2 diabetes mellitus respond to motivational interviewing. Diabetes Res Clin Pract. 2012;95(1):37–41 http://www.ncbi.nlm.nih.gov/pubmed/21899911 Accessed Jun 5, 2013 - PMC - PubMed

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