Shared Decision-Making: What It Means to Me as a Person With Autoimmune Arthritis
by Eileen Davidson, Arthritis Patient Advisory Board Member
Living with rheumatoid arthritis and non-radiographic axial spondyloarthritis means my disease affects every part of my life. Because arthritis touches my health, work, relationships, and daily functioning, having a say in the decisions about my care is essential.
What Shared Decision-Making Means in Arthritis Care
Shared decision-making is a partnership. It’s a collaborative process in arthritis care where clinicians and patients make decisions together. Shared decision-making supports patients in understanding all available options, including the option of no treatment, and helps identify the best course of action for their individual situation.
That partnership is something Arthritis Research Canada scientist Dr. Glen Hazlewood studies closely. He describes it as a process that goes beyond simply presenting options to patients.
“Shared decision-making means bringing together the best available evidence and the patient’s values and preferences to arrive at a decision together,” he explains. “There often isn’t one single ‘right’ answer in rheumatology, so the patient’s perspective is essential.”
Dr. Hazlewood’s research examines how shared decision-making can be more effectively integrated into rheumatoid arthritis care. His work aims to identify practical ways clinicians can create space for meaningful conversations, ensuring patients feel heard, respected, and informed.
Beyond the Rheumatologist’s Office
Managing autoimmune arthritis is not limited to medications alone. Shared decision-making extends across an integrative healthcare team that includes occupational therapists, physiotherapists, social workers, and counselors. Each provider brings a different perspective, but the goal remains the same: to provide care that aligns with a patient’s goals, limitations, and daily realities.
As Dr. Hazlewood notes, “Decisions about arthritis care don’t happen in isolation. They involve conversations about daily function, mental health, work, family responsibilities, and long-term goals.”
Why Shared Decision-Making Matters
As my understanding of my disease has grown, decision-making has felt less overwhelming. Knowing the risks of untreated disease has made me more confident in my choices, and shared decision-making continues to evolve as my health and priorities change.
When I needed to switch medications, my rheumatologist used simple side-by-side comparisons and visual aids to explain my options. Because appointments can feel overwhelming, having materials to review later helped me feel informed and confident in our decision.
While shared decision-making is essential, challenges remain. Patients may not feel empowered to speak up, and clinicians may face time or resource constraints.
One example is a decision aid tool Dr. Hazlewood is evaluating for people with rheumatoid arthritis who are considering reducing or stopping biologic medications. Tools like this help patients understand their options and have more productive conversations with their doctors.
Shared decision-making is especially important for people with rheumatic diseases because it acknowledges that each patient’s journey is unique. It empowers patients, improves care, and helps tailor treatment plans to individual needs and circumstances.
When I am actively involved in decision-making, I feel empowered rather than overwhelmed. I am informed and confident, rather than confused. Shared decision-making allows me to take an active role in managing my health, rather than feeling like decisions are being made for me. I’m not just receiving care. I’m helping to shape it.
