The 10 commandments of patient-centred care

A team of UK researchers has transformed their paper, published in the British Journal of General Practice, into a website fully dedicated to covering the 10 commandments for patient-centred treatment. Although it is about general practice, the principles are similar for any health profession, particularly where the profession involves disgnostics, prescribing medications or giving medications advice.

If you are health students who are starting clinical placements for the first time this year, it would be difficult to go too far off track if you were following the 10 commandments:

  1. the ten commandments for patient-centred carePatient Goals – Do not make assumptions. Patients’ aims need to be understood before you propose a course of action based on the nature of the illness (first diagnosis) and patients’ goal (second diagnosis).
  2. Seek Knowledge – Basically, you need to know the benefits, harms, and costs of treatment, share the knowledge with people in ways they can understand, and apply it to the goals and preferences of patients.
  3. Watchful Waiting – There will be a time when prescribing something seems to be an easier way, when there are no clear diagnosis or none at all. But when the time comes, always choose to keep the offer open of another consultation.
  4. Balanced Sources – Keep your sources of knowledge balanced. Always choose reputable sources and avoid industry-sponsored sources of information.
  5. Treat Risk, Not Risk Factor – The offer of preventive treatment should not be addressed to the reduction of a single risk factor, but to the totality of risk for a particular outcome.
  6. Treatment Target – Do not let externally imposed targets take over the essential process of dialogue and shared decision making in treating patients.
  7. Older Patients – Be honest about possible benefits, harms, and uncertainties to older patients. Establish a clear understanding of what they are experiencing while on treatment, and what they would like to achieve.
  8. Stopping Medications – Patients often do not volunteer adverse effects and clinicians often ignore reminders, so always consider what drugs you can stop and reassess the need for all treatments regularly.
  9. Best Treatment – Try to find the best treatment for the individual, because different treatments work for different people. Take the cost and efficacy into account.
  10. Minimize Drugs and Dose – Use as few drugs as possible. Do not use drugs as a shortcut because alternatives might take more time to explain or be harder to access.

If you are interested in the key paper that delivered this 10 commandments, it will become open access in October 2016.

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Image: John Taylor – flickr

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