Nurse medicine. Central to this model is an emphasis on treating the patient as a whole person, including the biological, psychological, behavioral, and social aspects of their health (Engel, 1980). The American Heart Association (AHA) in collaboration with other professional societies has issued a new scientific statement for the management of patients with advanced heart failure. It emphasizes ‘shared decision making’ and is designed to help physicians and other health professionals align medical treatment options with the wishes of the patients. Allen (2012) recognises the complexity of heart failure and complexity of the treatment options can be a barrier to shared decision making, but this only emphasizes why such a patient-centred approach should be undertaken in Advanced heart failure. Shared decision making has received particular emphasis in relation to the prescribing of drug treatments. Traditionally, studies have identified 50% of patients with chronic conditions do not take their treatment as prescribed, with major reasons being because they do not share the doctors views, or they are worried about side effects. (REF QUOTE?) Therefore the aim is to explore these issues by adopting a shared decision making approach and reach a ‘concordance’ between doctor and patients.
Therefore getting patients involved in the planning and management of care, being sensitive to the individuals need, spending time figuring out what is important to them, will hopefully reduce some of the confusion and complexities concerning heart failure. Although knowledge alone does not insure compliance, patients can only comply when they possess some minimal level of knowledge about the disease and the health care regimen. (Van der wal, 2006).
The National Prescribing Centre (2012) designed a competency framework which can be seen in appendix 3. One of the three domains is the consultation which highlights three areas of importance 1; Knowledge; pharmacological and pharmaceutical. 2; Options; concerning the diagnosis and management 3; Competency; involving ‘shared decision making’ with parents, patients and carers. The data is clear that for the benefit of the patient and success with the treatment
