Scarlett McNally: GPs and geriatricians can help to improve shared decision making for surgical patients

The BMJ Pub Date : 2024-11-13 DOI:10.1136/bmj.q2478
Scarlett McNally
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Abstract

At one of my first meetings as an elected council member of the Royal College of Surgeons of England, we approved a report called Access All Ages . It encouraged less ageist thinking and bias among healthcare staff that might lead to them denying older people surgery.1 But sometimes an operation isn’t the best option. Among patients who have surgery, 14% express regret and 15% experience complications, which are at least four times as likely if they’re frail or physically inactive.2 The Centre for Perioperative Care has published information on the importance of exercise before surgery,3 but that alone may not be enough. We need shared decision making,4 including asking patients what matters to them. The public should be primed to ask about BRAN—the benefits, risks, and alternatives to surgery and the likely result from doing nothing.4 A slew of data …
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斯嘉丽-麦克纳利全科医生和老年病学家可以帮助改善手术患者的共同决策
在我当选英国皇家外科学院理事会成员后的第一次会议上,我们通过了一份名为《Access All Ages》的报告。该报告鼓励医护人员减少可能导致他们拒绝为老年人进行手术的年龄歧视思想和偏见。在接受手术的患者中,14% 的人表示遗憾,15% 的人遭遇并发症,如果他们身体虚弱或缺乏运动,出现并发症的几率至少是前者的四倍2 。我们需要共同决策4 ,包括询问患者什么对他们最重要。我们应该让公众了解 BRAN--手术的益处、风险、替代方案以及什么都不做的可能结果4。
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