Abstract
Shared decision making (SDM) means that clinicians and the patient make decisions about the treatment together. Regarding drug treatment in eating disorders (EDs), such decisions may include psychopharmacological treatment for the ED itself, medications for potential co-morbid psychiatric disorders, pharmacological strategies to alleviate the health consequences of an ED or “pro re nata” (PRN) medication which is given in acute care when required.
Decisions regarding drug treatment in EDs should be specific in terms of the active pharmacological substance, its dose, its route of administration and the duration of treatment. Decisions should be made with regard to the specific health risks of patients with EDs and the entire treatment approach, and should take alternative measures, additional therapies and specific combinations of therapies into account.
The differences in the expectations of patients, carers and clinicians towards drug treatment, the lack of specific suggestions in clinical practice guidelines and the lack of approved psychopharmacological treatment options make SDM necessary, but also a challenge.
However, SDM may be limited due to the patient’s impaired insight or limited capacity due to the ED. Thus, the legal framework must be taken into consideration.
Decisions regarding drug treatment in EDs should be specific in terms of the active pharmacological substance, its dose, its route of administration and the duration of treatment. Decisions should be made with regard to the specific health risks of patients with EDs and the entire treatment approach, and should take alternative measures, additional therapies and specific combinations of therapies into account.
The differences in the expectations of patients, carers and clinicians towards drug treatment, the lack of specific suggestions in clinical practice guidelines and the lack of approved psychopharmacological treatment options make SDM necessary, but also a challenge.
However, SDM may be limited due to the patient’s impaired insight or limited capacity due to the ED. Thus, the legal framework must be taken into consideration.
| Original language | English |
|---|---|
| Pages (from-to) | 332-346 |
| Number of pages | 15 |
| Journal | International Review of Psychiatry |
| Volume | 31 |
| Issue number | 4 |
| Early online date | 14 Mar 2019 |
| DOIs | |
| Publication status | Published - 19 May 2019 |
Keywords
- Shared decision-making
- anorexia nervosa
- binge eating disorder
- bulimia nervosa
- eating disorders
- psychopharmacological treatment
