Abstract

In the past, physician-patient relationship was mostly unilateral and disease-centered as the physician made all the disease-related decisions on behalf of the patients. Nowadays, based on different cultural and legal aspects, the physician-patient relationship relies on the shared decision making (SDM) process. SDM is the approach where health professionals and patients decide the best approach on disease-related decisions. In this process, patients receive from clinicians and health professionals other than medical doctors the support and all relevant information to analyze the different available options and to identify their preferences in terms of tests, treatments and daily management of the disease. In this context, SDM has a positive impact in clinical practice allowing the integration of the physician's point of view with the patients' perspective. The main target of SDM is to achieve the most effective, most satisfactory and best tolerated approach to optimize diagnostic, therapeutic and overall management strategies through: i. patients' awareness and attitude towards the disease, ii. patients' self-confidence, iii. tailored therapy, iv. therapy adherence, v. informed decision regarding disease-related daily life issues. In the field of rheumatic and musculoskeletal diseases (RMDs), the SDM process requires a multidisciplinary team involving not only rheumatologists but also other specialists and health care professionals, other than medical doctors, specialized in rheumatology. However, the multidisciplinary team pursuing this patient-centered approach, should be guided by the rheumatologist that has the widest point of view regarding all possible aspects of the disease. Such multidisciplinary approach ensures that patients are fully aware of all aspects of the disease, of how their life may be affected and, most importantly, of how to manage different situations. Patients with distinct RMDs suffer from different complaints and require different treaments according to the diagnosis. Moreover, it is well established that young people with RMDs have different priorities and needs compared to adult patients. Finally, subjects included in different age ranges within young patients are further different from each other. This requires an additional effort of the multidisciplinary team to tailor the support to specific circumstances. Self-confidence, working disability as well as social life, family life and intimacy represent some of the domains mostly affected in young patients with RMDs. Therefore, the interaction of rheumatologists, other specialists, and health professionals specialized in rheumatology is compelling to optimize the management as well as the SDM process with young patients with RMDs. In conclusion, empowering young patients with RMDs to know and manage their own condition is crucial for long-term improvement of their quality of life and should be thoroughly applied in clinical practice.