Exploring doctor and patient views about risk communication and shared decision‐making in the consultation

Davis, Ruth; Dolan, Gina; Thomas, Sue; Atwell, Christine; Mead, Donna; Nehammer, Sarah; Moseley, Laurence; Edwards, Adrian; Elwyn, Glyn

doi:10.1046/j.1369-6513.2003.00235.x

Cited by 77 publications

(85 citation statements)

References 13 publications

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“…23 Recent studies demonstrate primary care physicians' recognition of CKD and common CKD risk factors are suboptimal. 24,25 Since primary care physicians play an important role in communicating health risks to patients, [26][27][28] it is possible their lack of awareness and knowledge regarding CKD may contribute to patients' inaccurate perceptions. Our findings support calls within the medical community for enhanced efforts to improve awareness of CKD among high-risk patients and their primary care physicians.…”

Section: Discussionmentioning

confidence: 99%

Perceived Susceptibility to Chronic Kidney Disease among High-risk Patients Seen in Primary Care Practices

et al. 2009

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BACKGROUND: Patients' views of their risk for the development or progression of chronic kidney disease (CKD) are poorly characterized.OBJECTIVE: To assess perceived risk and concern regarding CKD development or progression among high-risk patients seen in primary care, identify predictors of perceptions, and correlate perceptions with adherence to high blood pressure management. DESIGN AND PARTICIPANTS:Cross-sectional study of 195 patients enrolled in a randomized controlled trial on hypertension management in 40 Maryland primary care practices. MEASUREMENTS:We assessed independent predictors (sociodemographics, health literacy, clinical presence of CKD, co-morbid conditions, and health behaviors) of perceived susceptibility (assessed via questionnaire) and adherence (assessed via Hill-Bone blood pressure adherence scale) in multivariable analyses. MAIN RESULTS:In this hypertensive majority African American (63%) population, many participants had uncontrolled blood pressure (44%) or diabetes (42%). Few (20%) felt "very likely" to develop CKD and one third (33%) were "very concerned" about developing CKD. Participants who were female and had low health literacy had lower perceived susceptibility to CKD compared to males and those with higher health literacy. Race and diabetes were also associated with perceived susceptibility. Greater perceived susceptibility was associated with poorer blood pressure management adherence scores.CONCLUSIONS: Many high-risk patients have low perceived susceptibility to CKD. Poor blood pressure therapy adherence scores among those with greatest perceived susceptibility suggest fatalistic attitudes about CKD. If our findings are confirmed in larger studies, interventions targeting patient perceptions of CKD risk and other attitudes associated with these perceptions could impact adherence to therapies and health outcomes.

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Section: Discussionmentioning

confidence: 99%

Perceived Susceptibility to Chronic Kidney Disease among High-risk Patients Seen in Primary Care Practices

et al. 2009

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“…Evaluation of an intervention to train practitioners in SDM techniques found that although training altered physicians' communication behavior, it had little effect on patients' satisfaction or sense of involvement in treatment decisions. 18 A recent study found that white and African American patients rated the participatory style of their physician higher in racially concordant visits; however, objective measures of patient-centered verbal behavior did not differ signifi cantly between racially concordant and discordant visits. 19 Understanding the relationship between communication skills, such as SDM, and subjective experience may require new research strategies.…”

Section: Introductionmentioning

confidence: 95%

Shared Decision Making and the Experience of Partnership in Primary Care

Saba¹

2006

The Annals of Family Medicine

176

153

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“…17 SDM research is expanding rapidly, but limited data are available thus far about how patients and professionals perceive SDM in actual practice. 18 For SDM in the mental healthcare context very few published studies are available. For the purposes of this paper, four published studies were located that included some elements of SDM.…”

Section: Knowledge About Sdm In Mental Healthmentioning

confidence: 99%

“…Sum scores up to 10 represent a sub-syndromal level of depression. Scores of 11 and more show a major depression with the categories mild (11)(12)(13)(14), moderate (15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27). The German version of the PHQ has been developed …”

Section: Brief-phq Surveymentioning

confidence: 99%

Depressed patients’ perceptions of depression treatment decision‐making

Simón

Loh

Wills

et al. 2006

Health Expectations

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Objective Little is known about the feasibility and effects of patientclinician shared decision-making (SDM) for depression treatment. Within a goal of informing the design of a SDM intervention, the objective of this study was to investigate depressed patientsÕ perceptions of the treatment decision-making process with general practitioners (GPs).Setting and participants Data were gathered from a convenience sample of 40 depressed patients to understand key aspects of treatment decision-making from the patient perspective. The sample varied in depression severity and type of setting in which treatment was sought.Main variables studied Semi-structured interview questions focused on patientsÕ prior experiences with depression and treatment, perceptions of the treatment decision-making process, and needs and expectations about treatment. Current depression severity was also assessed.Results Patient lack of insight regarding depression severity substantially delayed patient engagement in treatment seeking and decision-making. Patients expected their GPs to be a first and main source of objective information and discussion about depression and treatment and to provide emotional support for decision-making. Patients also identified needs for additional information about depression and its treatment, as well as concerns about certain aspects of treatment.Conclusions The depression treatment context has some aspects that differ from treatment decision-making for other types of health conditions. SDM approaches for depression treatment should be adapted based on depression severity and patientidentified needs.

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Exploring doctor and patient views about risk communication and shared decision‐making in the consultation

Cited by 77 publications

References 13 publications

Perceived Susceptibility to Chronic Kidney Disease among High-risk Patients Seen in Primary Care Practices

Perceived Susceptibility to Chronic Kidney Disease among High-risk Patients Seen in Primary Care Practices

Shared Decision Making and the Experience of Partnership in Primary Care

Depressed patients’ perceptions of depression treatment decision‐making

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