ABSTRACT
The importance of patient involvement in most aspects of health care is increasingly recognised. In the UK NHS, the ‘expert patient’ programme has been running for a number of years and has trained many people in how to become an expert in their own disease. In a similar programme, the DAFNE (Dose Adjustment for Normal Eating) trial is testing a new approach to diabetes management, which trains people with type 1 diabetes to take greater control of their condition. This programme is described by the organisation Diabetes UK, as a programme which ‘teaches people how to adjust their insulin doses to fit with their own lifestyle, rather than having to bend what they do and eat to a preset insulin regimen’. There are also now substantial programmes of research and development into decision aids which allow people to take decisions about their own care. Nearly 500 decision aids are listed in the Cochrane Database of Decision Aids, covering a wide variety of diseases and interventions, from warts and acne to prostate cancer screening and breast cancer surgery. In the United States and Canada, the Foundation for Informed Decision Making and the Ottawa Health Decision Center (OHDEC) at the Ottawa Health Research Institute have led the way in designing and collating information about decision aids. And the World Wide Web allows unprecedented access to health information, which is widely used.
