Provider

• Clarify objectives of therapy

• Ensure that the patient’s decision reflects their goals and preferences

• Screen for missed appointments

• Engage the patient and ask them to describe their medication regimen, such as when they take their medication and what the medication is for

• Use of communication skills (e.g., motivational interviewing, 5 A’s model)

• Define and explain the problem

• Present options

• Discuss pros and cons (e.g., benefits, risks, costs)

• Elicit information regarding patient’s values and preferences

Examine individual’s readiness to change

• Explore patient’s self-efficacy

• Anticipate and avoid common patient misperceptions

• Offer recommendations

• Check and clarify patient understanding

• Move or defer a decision, if needed, and arrange follow-up

Patient

• Understand knowledge, beliefs, and attitudes about treatment

• Determine ability to attain therapeutic goals

• Ask providers to explain the therapeutic options in order to make decisions concordant with goals and preferences

• Articulate personal goals and preferences

• Set and manage expectations of the treatment plan

Healthcare system

• Support for training in motivational interviewing, and shared decision-making

• Provide evidence-based shared decision-making support tools

• Use information technology to help educate and support their patients

• Support the patient and provider team across the continuum of care