Main Questions Post
The Impact that Patient Preferences, SDOH, and Values Have o
Main Questions Post
The Impact that Patient Preferences, SDOH, and Values Have on a Treatment Plan
For this week’s discussion, I reviewed the topic and decision aid for hyperthyroidism (Graves’ disease). Graves’ disease is an autoimmune condition that leads to an overstimulated thyroid gland and excessive thyroid hormone production (The Ottawa Hospital Research Institute, 2023). This topic is of great interest to me as an employee of an outpatient endocrinology specialty clinic. We care for patients with Graves’ disease and often face the difficult task of following treatment guidelines while incorporating patient preferences, values, and social determinants of health (SDOH) into the treatment plan. Patient values and preferences are their expectations, beliefs, affinities, and priorities for health and life and may apply to specific circumstances when one is considering the potential benefits, burdens, and costs of management options (Zeng et al., 2023).
A patient recently presented to my clinic for a follow-up on her Graves’ disease. She has received treatment with a medication called methimazole, which lowers endogenous excess thyroid hormone levels. During the visit, the patient endorsed being free of symptoms for the last several weeks. She also mentioned self-stopping the methimazole due to recent financial hardship. Economic stability is one of the five domains of SDOH that can affect the health, functioning, and quality of life of an individual (Walden University, 2024).
A review of lab results showed continued normal thyroid hormone levels despite being off of the methimazole for several weeks. A decision was made by the provider for the patient to continue off of the methimazole, monitor lab work periodically, and if the thyroid hormone levels become elevated again, we will work with the patient to obtain financial assistance so that she can resume the medication.
How a Patient Preference May Impact the Trajectory of the Situation
Including the patient’s preference to discontinue the methimazole has not done much to impact the trajectory of the situation. The treatment plan can continue without change since the patient was asymptomatic with normal lab results. It will be important to monitor the patient’s labs periodically and advise her to self-monitor for any symptoms of hyperthyroidism, including palpitations, hand tremors, anxiety, and any other abnormal symptoms that may be of concern to her.
The Value of the Patient Decision Aid
The patient decision aid I selected can be valuable for both healthcare professionals and, in particular, for our patients. The decision aid provides quality information about the disease process, causes, symptoms, and potential treatment and can be used in my professional practice while seeing patients. The decision aid also explains that, in general, treatment is a joint decision between the patient and provider (The Ottawa Hospital Research Institute, 2023). This is also relevant to my patient’s situation. However, my patient should have contacted our office prior to discontinuing her medication to discuss her options, and she was educated to do this in the future to avoid potential complications.
References
The Ottawa Hospital Research Institute. (2023). Graves disease. https://decisionaid.ohri.ca/Azsumm.php?ID=2074 Links to an external site.
Walden University. (2024). Social determinants of health. https://academicguides.waldenu.edu/Library/sdoh Links to an external site.
Zeng, L., Helsingen, L. M., Bretthauer, M., Agoritsas, T., Vandvik, P. O., Mustafa, R. A., Busse, J., Siemieniuk, R. A. C., Lytvyn, L., Li, S.-A., Yang, M., Yan, L., Zhang, L., Brignardello-Petersen, R., & Guyatt, G. H. (2023). A novel framework for incorporating patient values and preferences in making guideline recommendations: guideline panel surveys. Journal of Clinical Epidemiology, 161, 164–172. https://doi.org/10.1016/j.jclinepi.2023.07.003 Links to an external site.