Objective

Shared decision-making is a patient-centered approach that involves a mutual discussion about management or treatment options, which account for the patient's underlying values and preferences for therapy. Little is known about the role of shared decision-making in the care of patients with food allergy.

Data Sources

A narrative review of the shared decision-making and food allergy outcomes literature in the past 20 years was performed.

Results

In shared decision-making, care must be taken to help clarify the patient's values regarding their care options, but not instill the clinician's values or preferences into that choice. It is essential to understand the mutual roles of the clinician in the process of providing evidence-based options for care, advocating for treatments that are aligned with their goals and preferences, and allowing patients to make fully informed decisions within this paradigm. Decision support tools such as decision aids can assist patients in the values clarification process, particularly in which preference-sensitive care exists, in which options hold significant tradeoffs and varying outcomes, and the decision is reflective of personal values and preferences. There are multiple potential preference-sensitive care scenarios in food allergy in which shared decision-making could be optimized, including the development of decision aids. These areas include early allergenic solid introduction, preemptive epinephrine use in which there is allergen exposure but no symptoms, automatic activation of EMS after using epinephrine, and choices of food allergy treatment. Only one decision aid in food allergy exists.

Conclusion

Shared decision-making is an approach that could greatly enhance food allergy care and improve patient-reported outcomes.

中文翻译：

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食物过敏患者的共同决策。

目的

共同决策是一种以患者为中心的方法，涉及到有关管理或治疗选择的相互讨论，这些选择或解释考虑了患者的基本价值观和治疗偏好。关于共同决策在食物过敏患者护理中的作用知之甚少。

数据源

对过去20年中共享的决策和食物过敏结果文献进行了叙述性回顾。

结果

在共同决策中，必须注意帮助阐明患者关于其护理选择的价值观，但不能将临床医生的价值观或偏好灌输给该选择。了解临床医生在提供循证护理方案，提倡符合其目标和偏好的治疗方法以及让患者在此范例中做出充分知情决定的过程中的相互作用至关重要。决策辅助工具（例如决策辅助工具）可以帮助患者进行价值澄清过程，特别是在存在偏好敏感的护理的情况下，其中的选择具有重大的取舍和不同的结果，并且决策反映了个人价值和偏好。在食物过敏中有多种潜在的对偏好敏感的护理方案，在这些方案中，可以优化共享决策，包括开发辅助决策。这些领域包括早期引入过敏性固体，先兆肾上腺素的使用（其中没有过敏原但没有症状），使用肾上腺素后自动激活EMS以及选择食物过敏治疗。在食物过敏方面仅存在一种决策辅助手段。

结论

共同决策是一种可以大大增强食物过敏护理并改善患者报告结局的方法。