Making Tough Treatment Decisions for Your Lung Disease

Whether you are a newly diagnosed patient with lung disease, or your symptoms have worsened, you may be faced with tough medical choices that don’t always have a clear answer. You and your healthcare provider will need to discuss options, consider pros and cons, and work together to agree on the treatment goal and best course of action for your treatment. It is helpful to understand how shared decision making works so you feel empowered to have a productive conversation with your healthcare provider.

Q: What is shared decision making?

Shared decision making is a conversational process by which you and your healthcare provider come to an agreement over health care decisions.¹ Shared decision making is one of many models for decision making within the patient/clinician partnership. It is sometimes called "informed decision making," "informed shared decision making," or "evidence-informed patient choice." Whatever its name, decision making is a process where both the patient and clinician share information with each other, take steps to participate in the decision-making process, and agree on a course of action.² This is most important when there are multiple treatment options and your preference as the patient is critical to determining next steps.

Q: How is shared decision making different from informed consent?

Informed consent means that a healthcare provider assesses the options and selects one for you. Then you need to agree/consent to allow the healthcare provider to act. For example, if you have bacterial pneumonia your doctor will prescribe antibiotics to treat your illness. There is no need for shared decision making because there is only one clear treatment available, but you still need to consent to the treatment plan your healthcare provider recommends.

Shared decision making requires more involvement from you – healthcare providers share the options, all necessary and available information about treatments³ and outcomes, and then you choose based on your preferences.

Q: When should I use shared decision making to decide on my lung disease treatment plan?

Shared decision making is an approach most helpful in difficult medical decisions when there is no clear-cut “right” answer. This can occur when:

• No clear best practice guidelines exist
• There is insufficient or weak evidence for existing treatments
• Many treatment options exist, and choice is required
• When the patient does not agree to accept the health care professional’s recommendation
• Negative side effects should be discussed⁴

If you have asthma, you may engage in shared decision making to determine if an inhaled corticosteroid is a good treatment option for you. Guidelines have determined this is an ideal course of action for treatment but there are many good options to choose from. Similarly, if you have idiopathic pulmonary fibrosis, you may discuss your treatment goal and available options for therapeutic treatments.

Shared decision making isn’t limited to therapeutic treatments. Depending on the chronic lung disease you have, other treatments discussed may include pulmonary rehabilitation, vaccination, tobacco cessation, supplemental oxygen, interventional or surgical options and educational classes.