Shared decision making is a key component of patient-centered health care in which clinicians and patients work together to make decisions and select tests, treatments, and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values. Shared decision making helps providers and patients agree on a healthcare plan. When patients participate in decision making and understand what they need to do, they are more likely to follow through (National Learning Consortium [NLC], 2018).

Thankfully, practitioners have many new diagnostics, therapeutics (both over the counter and prescription), instruments, and treatments aimed at their dry eye patients. The course of dry eye therapy is generally chronic, as ocular surface challenges and patient symptoms may wax and wane, requiring a dynamic treatment paradigm. Do practitioners query their patients as to which medications and treatment modalities they prefer and/or with which they could remain compliant? How do patients feel about pharmaceutical use? Do patients have the capacity to comply with varied and complex regimens? Are physical limitations a concern? Is there an economic barrier to the process? What are the patients’ goals and concerns? Are patients flexible with changing recommendations?

A Win-Win Process

Most clinicians agree that patient education regarding ocular surface disease (OSD) is paramount to paired success in case management. NLC—a virtual body of knowledge and tools designed to support healthcare providers and information technology professionals working toward the implementation, adoption, and meaningful use of certified electronic health record systems—suggests that shared decision making allows patients to learn about their disease process and recognize that an informed decision of therapy needs to be made.

Patients are made to understand the pros and cons of different options and are given the information and tools needed to evaluate those choices. Shared decision making helps patients understand what clinicians are aiming to accomplish; they are better prepared for dialogue with their practitioners and can be collaborative in making care decisions that are right for them. Often, there is more than one reasonable option or no single option has a clear advantage.

Samples of shared decision tools for other pathologies, such as for heart pain and diabetes treatment, are available online at https://shareddecisions.mayoclinic.org .

Success in OSD treatment requires a collaborative effort and treatment buy-in from patients. Shared decision making can help define patients’ priorities and goals in the setting of a care plan that is attainable for them across a number of parameters. A better understanding of what “success” would look like not only clinically, but for the patients, can drive practitioners’ tailored management plan for every individual. Practitioners can look forward to building tools to help their OSD patients travel a dynamic, precision therapy path tailored specifically to them. CLS

For references, please visit www.clspectrum.com/references and click on document #274.