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Wednesday, March 26, 2008 3:30 PM

Navigating Health Care: Tips for Evaluating Treatment Advice

Debra: We have TV commercials for prescription drugs that promise to relieve many medical conditions but then warn us of all their unpleasant side effectsWe can undergo treatment to cure a disease but which could also have serious risksSometimes it’s hard to know what’s the right choice when it comes to our treatment options. In this segment of Navigating the Healthcare System, AHRQ Director Dr. Carolyn Clancy talks about how consumers can make more informed choices, weighing the benefits and risks based on evidence-based information.

Debra: Dr. Clancy, we hear the terms "risks" and "benefits" all the time, but what do they really mean?

Dr. Clancy: Well, benefits are pretty straight forward that’s the positive effect you expect as a result of taking medication, having a procedure done, and so forth. Risks includes a very broad category of outcomes that most of us aren’t in search of, and can range from a minor irritation, such as a rash that goes away if you stop the medication to something much more serious, like incontinence following surgery.

Debra: So, how do we weigh the risks and benefits to make a decision that works for us?

Dr. Clancy: It’s really important to understand that every treatment whether it involves medication, surgery, or some other type of intervention involves a degree of risk. So even taking an over-the-counter medication, like aspirin, can have side affects in some people. All of us need to find a balance that we’re comfortable with; for example, can you live with the side affects of a medication?

Debra: But where can we find information to evaluate risks and benefits of a treatment or procedure?

Dr. Clancy: You should consult with your doctor, particularly for those recommendations that he or she is prescribing for your benefit. He or she can help you evaluate the pros and cons of various options, and can also tell you having made a recommendation whether there are other options available for the problem that you have. Working as a partner with your doctor, you can decide on the best treatment option for your needs.

Debra: You often talk about the importance of having evidence-based information. How can we find out what the evidence says, or whether enough evidence is available to make a decision?

Dr. Clancy: Sometimes there isn’t evidence and, in fact, one of the most challenging aspects of clinical medicine is when a decision clearly needs to be made either because it’s a fairly acute situation or because the symptoms or disease state has become intolerable for an individual and there isn’t really good information. Most of the time informed decision making is going to be more effective for those situations where you’ve got a bit more time to contemplate what are my options? and which one would be best for me? Your doctor is a good source. You can also go to the Internet for more information and sometimes a medical librarian can help you as well. AHRQ’s Effective Health Care program is also a growing source of information that doesn’t say you should do this or that. What it says is Here’s what the best evidence shows us about what works, what doesn’t, for which patients, and what might be some side effects?

Debra: Dr. Clancy, are there specific questions that we should be asking the doctor when consider treatment options?

Dr. Clancy: If you work with your doctor, using the best possible scientific information, you can find out what are all the possible options for treating, and what are the associated risk and anticipated side affects. What your doctor considers a small risk may be something that you’re going to find intolerable. So without the very clear conversation, you’re not going to know that.

Debra: And what else would be helpful to know when weighing risks and benefits of treatment advice?

Dr. Clancy: I think it’s very important to know that people who are active participants in their own care, in general, have better outcomes than those who are not active and engaged. Now, again, most people have different decision making styles, but at the end of the day, the majority of individuals actually want to know about all of the options, even if they, then, turn to a physician and say, "Doctor, what would you specifically recommend?" If you are an engaged participant in the process, the more information you can gather, the better, because, at the end of the day, you and your physician share a common goal: finding the treatment that works best for you, the individual.

Debra: Dr. Carolyn Clancy, thank you very much for your time.

Dr. Clancy: Thank you for having me.

Debra: To check out AHRQ’s Effective Health Care program and read research reviews and summary guides on various health care topics, such as Type 2 Diabetes and antidepressant medications, go online to www.effectivehealthcare.ahrq.gov/.

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