Shared clinical decision making

@#Most patients want to play an active role in their own health care. There is now a movement from medical paternalism to patient-centered care in the consultation process that is based on the therapeutic alliance and negotiation between the doctor and patient, aptly named “shared decision-making” (SDM). It is a process where doctors work together with patients, including their families and caregivers, to select tests, treatments, management, or support packages, based on clinical evidence and personal informed preferences, health beliefs, and values. Successful implementation of SDM is associated with improved quality of consultations, favorable patient-reported health outcomes, and increased patient and doctor satisfaction. Patients are empowered to make proactive health decisions resulting in decreased anxiety, faster recovery, increased treatment compliance, and reduced unnecessary health care expenditure. There are multiple existing models in facilitating SDM. Two simple and easyto-follow models are the “three-talk model” and “S.H.A.R.E. approach.” The three-talk model endorsed by the NICE divides the SDM consultation into three steps, namely: team talk (explaining the need to consider treatment options as a team), option talk (describing the alternatives in more detail, and making use of patient decision aids [PDA] whenever appropriate), and decision talk (helping patients explore and form their personal preferences). On the other hand, the S.H.A.R.E. approach promoted by the Agency for Healthcare Research and Quality (AHRQ) is a five-step SDM consultation process that includes exploring and comparing the benefits, harms, and risks of each treatment option through meaningful dialogue about what matters most to patients.

Knowledge, attitudes, and practices of patients in using telemedicine for primary care consultations at a community-based clinic chain in Pasig City, Metro Manila: A cross-sectional study

Introduction@#Due to COVID-19, face-to-face human interaction has become a health risk. There is a need to adopt technology to provide alternative means in delivering health care for those who are unable or unwilling to see a doctor in person.@*Objective@#The objective was to determine the baseline knowledge, attitudes, and practices of patients in using telemedicine for primary care consultations at a community-based clinic chain in Pasig City, Metro Manila@*Methods@#The study utilized a multi-center, cross-sectional descriptive design. A 34-item self-administered questionnaire was devised, pilot-tested, and distributed to 242 respondents in 4 clinics in Pasig City from October to November 2020.@*Results@#A total of 242 questionnaires were distributed with 100% response rate. Telemedicine awareness was at 44.6%. There is a favorable attitude towards telemedicine. Only 20.25% had experience in using telemedicine. Among those who had experience with telemedicine, the most used device was the mobile phone (93.4%). The respondents had various resources, with cellphone signal (47.9%) and mobile data (45.9%) being the most common. The respondents prefer phone calls (48-57%) as their primary telemedicine platform followed by video conferencing (36-40%).@*Conclusion@#Telemedicine awareness and utility in the surveyed community remain low despite the information and communication technology (ICT) resources available and information drives being conducted. Preliminary data suggest that the majority of the surveyed community is open to the idea of telemedicine. Phone calls and video conferences using mobile phones are the modalities of choice for consultations. A follow up study with a larger sample size and more inclusive sample is recommended