How to facilitate shared decision making

An open question, such as ‘what are your thoughts about your bone health?’ can be helpful to find out a bit more about what people already know or think.

Or you could ask ‘Is osteoporosis something you have heard of before? And then use an open question such as ‘Can you tell me more?’

Asking these questions can help find out what people already know about the condition, their risk factors and bone strength and give you an idea about how prepared they might be to receive a diagnosis of osteoporosis or be offered osteoporosis medicines.

It is best to try and avoid questions like ‘what do you know about…?’ because people can feel like they are being tested and feel defensive.

That’s not quite right.

Julie hasn’t mentioned medicines.

Julie’s experiences with her mother meant that she recognised the importance and potential consequences of osteoporosis which is likely to increase her motivation to do something about it.

That’s not quite right.

Julie hasn’t mentioned other medical conditions.

Julie’s experiences with her mother meant that she recognised the importance and potential consequences of osteoporosis which is likely to increase her motivation to do something about it.

That’s correct!

Julie’s experiences with her mother meant that she recognised the importance and potential consequences of osteoporosis which is likely to increase her motivation to do something about it.

That’s correct!

Terry has heard negative things about osteoporosis treatments, which has increased his concerns about taking a bisphosphonate.

That’s not quite right.

Terry may know something about osteoporosis but we don’t know that he thinks it is important. He has heard negative things about osteoporosis treatments, which has increased his concerns about taking a bisphosphonate.

That’s not quite right.

Terry hasn’t mentioned other medical conditions. He has heard negative things about osteoporosis treatments, which has increased his concerns about taking a bisphosphonate.

That’s not quite right.

Ajay hasn’t mentioned medicines. He has a number of medical conditions that he may be more concerned about.

That’s not quite right.

Ajay has stated he is unsure about what osteoporosis is. He has a number of medical conditions that he may be more concerned about

That’s correct!

Ajay has a number of medical conditions that he may be more concerned about.

Julie sounds like she already knows about osteoporosis, what it is and why it is important. She might have an idea about causes of osteoporosis, and suspect it is due to her family history.
She might not know that there are positive steps to improve bone health, if her mother had no treatment. This means we might spend less time explaining the importance of osteoporosis and move more quickly to discussing how bone health can be treated

Ajay might need an overview of osteoporosis and explanation about the potential consequences, so he can see how it is important relative to his other medical conditions. It might be helpful to discuss how his osteoporosis might link to his other conditions e.g. if his other conditions increased his risk of osteoporosis.

That’s not quite right.

It’s best to understand what his concerns are in more detail so you address them specifically

Persuasion is not a successful technique when trying to change behaviour and usually has the opposite effect. Terry may already believe that osteoporosis is important, and needs his concerns exploring, not further emphasis of how important medicine is.
People tend to think in black and white rather than risk, so if someone he knows has experienced a side effect, telling him side effects are rare is unlikely to be helpful.
Offering him a different drug might be helpful, but he still might be concerned about side effects

That’s correct!

It’s best to understand what his concerns are in more detail so you address them specifically

Persuasion is not a successful technique when trying to change behaviour and usually has the opposite effect. Terry may already believe that osteoporosis is important, and needs his concerns exploring, not further emphasis of how important medicine is.
People tend to think in black and white rather than risk, so if someone he knows has experienced a side effect, telling him side effects are rare is unlikely to be helpful.
Offering him a different drug might be helpful, but he still might be concerned about side effects