Respond to both students discussion.
Patient involvement in their treatment plan is extremely important. Evidence-based medicine should begin and end with the patient. (Hoffmann et al., 2014) Decision aids are distinct from patient education programs in that they serve as tools to enable patients to make an informed, value-concordant choice about a particular course of action based on an understanding of potential benefits, risks, probabilities, and scientific uncertainty. (Schroy et al., 2011)
A patient in custody came in hypertensive. The patient's blood pressure was running 185/100-195/110. The gentleman refused medication and insisted he would walk, decrease salt intake, lose weight, and drink plenty of water. He explained to me his dad had hypertension and managed it just fine without any medications. I educated him on the risk, of stroke, heart attack, and possible death from refusing the medications. He verbalized understanding but insisted on trying his treatment plan without medications for one week. The provider on call was notified of the situation and stated we had to respect his decision and to take BP every day for one wk. Although this particular patient was not making the best decision for his health, in my opinion, I respected it. After a week, his BP did not come down despite his lifestyle changes. He then agreed to try the medication which bought it down. I explained to him all the things he wanted to try in his treatment plan are great and will lower his BP if he continued over a longer period of time, however, while in custody my job was to make sure he was safe and educate him about the consequences of not taking medication.
The decision aid, High Blood Pressure: Should I Take Medicine? (A to Z Summary Results - Patient Decision Aids - Ottawa Hospital Research Institute, 2022) Would have been helpful to me and to the patient during this time. I will utilize this in the future as it is giving the patient all the tools to make an informed decision regarding their healthcare. He would have the ability to see, this was not my opinion this was something recommended by the pateint decision aid as well. This tool could have assited him in making a better healthcare deciasion from day one. Although there was no conseuence to his decision, he could have suffered from a stroke or worse. If this aid was utilized in the beginning, he may have made a better treatment plan choice for the beginning.