We need to talk about risk

29 October 2021
Autumn 2021

Optometrists must make plain to patients the risks and benefits involved in any eye treatment or care. Rima Evans asks how they can sharpen their communication so patients feel fully informed.

COVID-19 has catapulted messaging about medical risk into the national conversation. Daily news coverage discusses risk in relation to the benefits and side effects of different vaccines, for example, or the risk of transmission for a person who is immunised compared with one who isn’t.

It could work in practitioners’ favour when it comes to how best they should communicate risks and benefits to patients.

As Adrian Edwards, Professor of General Practice at Cardiff University and co-author of a BMJ paper entitled ‘Communicating risk’ (Ahmed et al, 2012), points out, events over the past year have heightened people’s awareness of risk: “They now want to know more about the pros and cons of options available to them.”

Balancing those pros and cons is the very purpose of risk communication in a clinical setting. “It involves conveying accurate information about the risk and benefits relating to a treatment and the treatment options in a way that’s understandable and usable to the patient,” says Adrian.

This is no easy task given that people’s appetite for risk and understanding of it varies so widely. It’s an everyday necessity, however. Conversations about risk are a critical part of discussions on healthcare for which, as Ahmed et al (2012) notes, there can be many decisions that have no single “best treatment” and require trade-offs between harms and benefits. In these scenarios, risk communication can lead to shared decision-making by promoting patient involvement.

Yet risk communication can go beyond sharing information and “endeavour to change beliefs or promote behavioural change” where there is good evidence of the benefits of an intervention, the research paper also explains. An example might be around encouraging patients to wash hands before handling contact lenses to minimise the risk of developing microbial keratitis.

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