Shared Decision Making in Asthma Management

Have you had a trip to the Emergency Room for your asthma and had to make a decision? Maybe you were presented with options to pick from or you were just presented with a diagnosis and a script. Perhaps you were not presented with further information or you didn’t know you had options. Maybe you wanted to have had your concerns or opinions heard, but your doctor didn't listen.

Remembering my first doctor's visit

I still remember being in my doctor's office and them telling me that I had an asthma exacerbation. I, at the time, had no idea what that was or what it meant. I had been asymptomatic for so long and I didn’t even think I had asthma.

If I had engaged in a more shared decision making discussion with my physician I would likely have received a more comprehensive diagnosis sooner and gained a better understanding of the medications they were suggesting that I take. I was really clueless and this was such a missed opportunity to have me more ownership in my own care and feel valued as part of the care team.

What is Shared Decision Making?

Shared Decision Making (SDM) a process in which patients work with their doctors to select treatments based on what’s most important to them. Doctors and patients discuss information about their health problems, treatment options, and what patients prefer.

What does the research say on shared decision making?

There is wonderful research being conducted by Dr. Hazel Tapp and her team in North Carolina. In the study, they implemented a training program in three arms; one arm trained physicians one hour a week over 12-weeks in SDM. The other arm trained in a lunch and learn style training program and the third arm received no training.¹

The researchers found more patients participated equally in making shared decisions with their providers in the practices that participated in the 12-week facilitator-led training arm.

Does your doctor make decisions equally with you?

I had a recent experience with SDM that honestly wasn’t so equal. I wonder how it might be possible to do that better? I definitely think that some of the physicians that I have encountered could use a visit from the facilitator-led training in shared decision making. In my opinion, even if people come to similar decisions, making a decision together can be a very powerful tool. Knowing that a decision is made in a supportive way can go along way to strengthen a doctor-patient relationship and offer peace of mind.

Do you think your physician would be receptive to receiving this training? How would you describe your level of engagement in your healthcare decisions?