Shared decision-making (SDM) is a patient-centered healthcare model fostering collaboration between patients, caregivers, and providers. For patients with generalized myasthenia gravis (gMG), SDM helps navigate complex treatment decisions while aligning care with individual preferences and values. This is particularly critical in gMG due to its diverse symptom burden and evolving therapeutic landscape.
Studies show that SDM improves decision quality, enhances patient autonomy, and reduces decisional regret. Tools like the SHARE approach guide providers through key steps: engaging patients, comparing treatment options, assessing values, making joint decisions, and evaluating outcomes.
Despite its benefits, barriers such as time constraints, inadequate patient education, and limited provider training often hinder SDM adoption. To overcome these challenges, interventions like decision aids and patient activation strategies have shown promise. While no single approach has been proven superior, training programs like the SDM-N scale can enhance provider competency and improve care quality.
In gMG management, SDM also promotes effective care coordination by facilitating communication between specialists, such as neurologists, and generalists, including PCPs, NPs, and PAs. This collaboration ensures that all members of the care team are aligned on treatment goals, enabling comprehensive, patient-centered care. By embracing SDM, providers can empower gMG patients to actively participate in their treatment, fostering better outcomes and stronger patient-provider relationships.
How do you integrate SDM into your gMG treatment planning? What strategies or frameworks have you found most effective in supporting patient involvement?
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Sachin Panchal2dI do not have many of this particular patient population but I would refer them to specialist -
Paola Sandroni, MAYO CLINIC HEALTH SYSTEM - MANKATO1wThere is no doubt that sharing decision making is critical in many conditions. Even when the option is only 1 is still important to give the patient the feeling that they are part of the decision because that helps compliance and accepting potential issue of tolerability and safety as well as cost of medication. And sometimes there isn't a clear choice and so having a decision taken together help establish a good relationship
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Muhammad Nawaz5moBeing an Internist and PCP always involved in the holistic and comprehensive care of the pt in all respect and gMG is no exception either, since deal with lot of HMO/Managed care pt so have pt interaction on frequent basis for the referral and coordination of care and review the Neurologist notes and communicate frequently with them for the care plan and review the meds being prescribed and their potential side effects and drug interactions and review pts their ability to pay and the support offered by the Pharm companies
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Swati Desai5moI am known to my patients for discussing medical conditions and treatment options with them- does take time but helps to improve patient compliance with treatment and follow up and leads to better control of their medical condition- same applies to gMG- knowing what to expect from their medical condition and treatment to include any side effects is key to patient- doctor trust and confidence
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Leon Ronen6moSDM is an important aspect of managing patients with gMG. Patients need to feel as though they have an input into the decisions regarding their health management. Patients need to understand and accept the treatment options and plan. This will usually improve adherence and results
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Michelle Santiago7moI try to integrate shared decision making in all of my patient appointments. I probably incorporate it most of all when discussing medication choices. I will typically go over multiple options for medication choices with the patient in great detail. We will go over the pros and cons of each and discuss which would be best in a collaborative way. I find this gets the patients buy in and typically promotes compliance with the patient.
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Rikki Racela, Bergen Neurology7moI integreate SDM in gMG treatment planning by really educating my patients about the disease and how treatments work. Some strateggies that I have found effective is not using jargon when talking about treatments and their potential side effects.
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Julie Lockwood, Neurology and sleep Medicine associates7moSometimes patients also need psychiatrists or counselors as part of the team as this disease can have emotional implications as well with adjusting to diagnosis and treatments.
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Indravadan Gatiwala, Neurology center of Lumberton, Inc7moShred decision making approach is helpful in many ways. It helps to make a decision in a different different areas of the medical problems patient may have it. . Patient get help for their the pulmonary symptoms from Pulmonologist, , generalized fatigue, cognitive issues - from neurolologist, , and during the crisis- they can have lot in making appropriate decision for the patient.
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Liang Lu8moI always take shared decision-making approach in managing patients with gMG, to help them navigate the complex treatment options. I strongly believe this patient-centric strategy can allow them to be more actively engaged in treatment plan, enhance medical compliance and clinical outcomes.
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William DeMedio9moI don’t have many patients with MG. If I did, I would refer major management decisions to the neurologist.