TY - JOUR T1 - When should you involve patients in treatment decisions? JF - British Journal of General Practice JO - Br J Gen Pract SP - 771 LP - 772 VL - 57 IS - 543 AU - Angela Coulter Y1 - 2007/10/01 UR - http://bjgp.org/content/57/543/771.abstract N2 - Three papers in this issue of BJGP call on doctors to adapt their practice styles to encourage more active patient engagement. Greaves and Campbell make a strong case for supporting self-care,1 while Bryant et al2 and Cox et al3 tackle the issue of how to involve patients in treatment decisions. There is an ethical, political, and scientific basis for moving in this direction, but the practical implications are complex.There is much evidence that engaging patients in treatment decisions and supporting their efforts at self-care can lead to beneficial outcomes.4,5 Patients who are active participants in a shared decision-making process have a better knowledge of treatment options and more realistic perceptions of likely treatment effects. The resulting treatment choices are more likely to concur with their preferences and attitudes to risk.6 Actively engaged patients are also more likely to adhere to treatment recommendations, and less likely to select expensive procedures.7,8 However, patients' desire to play an active role in decision making varies, and, according to Cox et al, GPs are not very good at predicting what role patients want to play.3 What should be done about this problem?Two possible solutions present themselves: asking patients explicitly whether they want to be involved in deciding how to manage their condition and adapting your decision-making style … ER -