There is a lack of guidance to clinical practitioners and patients about how to accomplish the prognosis approach in routine clinical practice.Even though principles of shared decision making are well documented but are not adapted in Indian Clinical Settings.Achieving shared decision making depends on building a good relationship and Trust of patient and patient family in the clinical encounter so that clinical information on prognosis is shared and patients are supported to deliberate and express their preferences and views during the decision making process.Clinicians have to explain the diagnosis and explain the prognosis of the patient and then to share the treatment options including alternate choice, cost-benefit, clinical risk and clear prognosis and hence clinicians must introduce treatment choice, describe treatment options, often by integrating the use of patient decision support, and helping patients and their families understand the clinical status of the patient, explore preferences and make decisions accordingly to what matters most to patients as individuals, and that this exploration in turn depends on them developing informed preferences. The counselling on treatment outcomes, family and social support, building positive emotions, sharing evidence based guidelines, financial matters and complete transparency and the ability of clinical teams to build trust and good communication will be important for better outcomes of treatment and exceed patient expectations.
