Download to read offline
Uploaded byØystein Eiring
Decide treatment - a new approach to better health
The document outlines the importance of health optimization for individuals with chronic disorders, detailing six common reasons for suboptimal health and strategies to achieve optimal health. It emphasizes the significance of shared decision-making between patients and healthcare providers, utilizing technology and various analytical frameworks to improve treatment adherence and outcomes. Strategies include finding the best available treatment, taking optimal dosages, leading a healthy lifestyle, and receiving adequate support.
More Related Content
Similar to Decide treatment - a new approach to better health
Decide treatment - a new approach to better health
- 2. • Physician • Psychiatrist •Editor • Head of department • Researcher • Chief adviser • Software developer
- 3. So many people, somany with chronic disorders
- 4.
- 5. I want tobe healthy!
- 6.
- 7. 1. Does notuse the best main treatment
- 8. 2. Does notuse the optimal dosages
- 9. 3. Difficult to taketreatment as agreed
- 10. 4. Difficult to leada healthy lifestyle
- 11. 5. Does notget enough support from others
- 12. 6. Is nothappy with the decision- making
- 13. HEALTH OPTIMISATION 1. Findsthe best available treatment 2. Takes the optimal dosage 3. Uses the treatment as agreed 4. Leads a very healthy lifestyle 5. Takes part in decisions 6. Receives enough support
- 14. An approach fromthe UK calling for the use of technology Figure 1. Summary of the four principles of medicines optimization
- 15. Increasing the effectivenessof adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments Bryan Haynes
- 16. Increasing the effectivenessof adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments Bryan Haynes And this is only problem #3 of the 6
- 17. 6 STRATEGIES FOR OPTIMALHEALTH
- 18. 1. Finds the bestavailable treatment 2. Takes the optimal dosage 3. Uses the treatment as agreed 4. Leads a very healthy lifestyle 5. Takes part in decisions 6. Receives enough support
- 20.
- 21. HVA ER BEST ÅGJØRE?TEKNISK STØTTE: • Systematisk monitorering av effekter • Monitorering av annen info, som søvn og labsvar • Optimalisering av compliance • Integrert kunnskap fra mange kilder • Rangering av behandlinger ut fra forskning og reelle effekter • Hjelp til å formidle kunnskap til henne på en forståelig måte • Hjelp til å involvere henne i valget Contributors:
- 22. London, Sydney, Seoul,Chicago, Odessa, Dubai, Singapore Professor Jack Dowie
- 23. Frameworks: 1. Multi-criteria decisionanalysis 2. Single subjects research designs 3. Shared decision-making
- 24. Multi-criteria decision analysis Mathematics Behavioraldecision theory Economics Computer technology Software engineering Information systems
- 25. Multi-criteria decision analysis Mathematics Behavioraldecision theory Economics Computer technology Software engineering Information systems • Includes exactly what is needed for optimal decisions • Enables valid and consistent integration of large amounts of data • Takes knowledge and preferences as input for calculations of treatment values for the individual
- 26.
- 27. • What worksfor groups of people generally does not work for you! Time DevelopmentVariable • Measure treatment effects and find out: Right: With treatment Middle: Without treatment Left: With treatment • Conclusion: Less symptoms with treatment!
- 28.
- 29. Shared decision-making1. Getthe decision on the table
- 30. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient
- 31. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table
- 32. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table 4. Ask what the patient wants the treatment to do for her
- 33. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table 4. Ask what the patient wants the treatment to do for her 5. Tell what the patient can expect from the best and worst treatment, on all outcomes
- 34. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table 4. Ask what the patient wants the treatment to do for her 5. Tell what the patient can expect from the best and worst treatment, on all outcomes 6. Find out which treatment fits her preferences most
- 35. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table 4. Ask what the patient wants the treatment to do for her 5. Tell what the patient can expect from the best and worst treatment, on all outcomes 6. Find out which treatment fits her preferences most 7. Agree on what is the best treatment
- 36. Shared decision-making1. Getthe decision on the table 2. Acknowledge that it´s not possible to find the best treatment without knowing what´s important to the patient 3. Get all available options on the table 4. Ask what the patient wants the treatment to do for her 5. Tell what the patient can expect from the best and worst treatment, on all outcomes 6. Find out which treatment fits her preferences most 7. Agree on what is the best treatment 8. Provide support and allow the patient to participate in the decision process to the extent and in the ways preferred
- 37.
- 38. Pilot: Bipolar disorder • Avery complex disorder • Highly invididual course and treatment results • Can be unpredictable • Serious consequences very common • Fatal consequences not rare
- 39. New knowledge summary methods •Fast and frugal • Patient-oriented • Decision-focused
- 40. New knowledge summary methods •Fast and frugal • Patient-oriented • Decision-focused Addresses all patient-important outcomes
- 41. DECIDE TREATMENT: 18 FEATURES TAILORED TOSOLVE THE 6 PROBLEMS
- 42. 1. Does notuse the best main treatment
- 43. 1. Does notuse the best main treatmentLet´s integrate all available knowledge!
- 44.
- 45.
- 46.
- 47. + Removes contraindicated andirrelevant options and outcomes
- 48.
- 49. = a fullypopulated decision matrix
- 51. Ranking and expectedvalue of available treatments
- 52. Ranking and expectedvalue of available treatments
- 53. Ranking and expectedvalue of available treatments No action is evidence- based in this world. All human behaviour is knowledge- and preference-based
- 54. What health isto her
- 55.
- 56. Ranking based ontrade-off + all evidence
- 57. Personalised ranking, ratherthan the recommendations for an “average patient” in clinical guidelines
- 59. Let´s pick one ofthe best!
- 60. Let´s find outhow they compare
- 61. 2. Does notuse the optimal dosages
- 62. 2. Can findthe best dosage
- 63. 2. Can findthe best dosage
- 64. 3. Difficult to taketreatment as agreed
- 65. 3. Reminded of, signsoff, look at together
- 66. 4. Difficult to leada healthy lifestyle
- 67. 4. Decides on, remindedabout, inspect
- 68. 5. Does not getenough support from others
- 69. 5. Decides on supportand receives it
- 70. 6. Is nothappy with the decision- making
- 71. 6. Decides on decisionquality and measures it
- 72. The patient´s treatment plan •Main treatment • Additional ones • Lifestyle measures
- 73. New side effects Lifeevents Treatment changes Appointments
- 74. Objective data • Fromthe mobile • From the watch • From EMR
- 75. Text, video, graphics reached withone click from the panels
- 76. 12 panels condensing huge amountsof data = Solid ground for shared decisions
- 77.
- 78. Where is shared decision-making? 1.Finds the best available treatment 2. Takes the optimal dosage 3. Uses the treatment as agreed 4. Leads a very healthy lifestyle 5. Takes part in decisions 6. Receives enough support here here here here here here
- 80.
- 81. Coordinated with andreflected in government whitepapers and initiatives
- 82. Systems in the makingfor people with: • Heart disease • Asthma • Stroke • Hypertension • MS • COPD • Diabetes • Bipolar disorder • Palliative care • Lung cancer • Schizophrenia • Pregnancy • HIV • Psoriasis/eczema
- 83. 5 studies asper 16.11.16 5 PhDs
- 84. Results: SUS score 78 Testedwith 88 potential users Norway, UK, Ukraine Above 68 is good
- 85. I don´t wantto stop using this Patients: I feel safer having this system I see the big picture very fast Doctors: We quickly get to the main issues Results:
- 86.
- 87. 24 interconnected modules enrichingeach other
- 88. Modules in patientdecision aids
- 89. Modules in clinicalpractice guidelines
- 90. You could bean author of a Health Helper!
- 92.
- 93. Take this and come backin a month
- 94. Take this and come backin a month We can continue with business as usual: • No systematic measurement of treatment effects • Trust that our brains can process all necessary data • No digital support outside of the encounter
- 95.
- 96. Finding out what worksfor you should be as systematic as finding out what works for groups (= research)
- 97. Optimisation of health foreach and every one of us 1. Finds the best available treatment 2. Takes the optimal dosage 3. Uses the treatment as agreed 4. Leads a very healthy lifestyle 5. Takes part in decisions 6. Receives enough support
Editor's Notes
- #16 Toril, as many of the others, would rightfully ask: What is the best treatment, the best medication, for me? This question could be part of quite different contexts. For instance.
- #17 Toril, as many of the others, would rightfully ask: What is the best treatment, the best medication, for me? This question could be part of quite different contexts. For instance.