More primary care patients regret health decisions if they experienced decisional conflict in the consultation: a secondary analysis of a multicenter descriptive study

Abstract

BackgroundWe sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret.MethodsSecondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician and consultation characteristics were collected before, during and immediately after consultations, as well as two weeks post-consultation, when patients completed the Decision Regret Scale (DRS). We examined the DRS score distribution and performed ordinal logistic regression analysis to identify predictors of regret.ResultsAmong 258 unique patient-physicians dyads, mean ± standard deviation of decision regret scores was 11.7 ± 15.1 out of 100. Overall, 43 % of patients reported no regret, 45 % reported mild regret and 12 % reported moderate to strong regret. In multivariate analyses, higher decision regret was strongly associated with increased decisional conflict and less significantly associated with patient age and education, as well with male (vs. female) physicians and residents (vs. teachers).ConclusionAfter consulting family physicians, most primary care patients experience little decision regret, but some experience more regret if there is decisional conflict. Strategies for reducing decisional conflict in primary care, such as shared decision-making with decision aids, seem warranted.

Psychological distress and quality of life following positive fecal occult blood testing in colorectal cancer screening

“…It consists of five items with Likert‐scale responses that were transformed into a total score of 0 to 100, with greater scores associated with higher regret 24 . Based on a validation study in prostate cancer patients, we considered a DRS score of >25 as high level of regret 24‐26 …”

Conflicto decisional en personas con diabetes mellitus e hipertensión arterial usuarias del nivel primario de atención de salud de Chile

“…Sin embargo, no basta con la mera entrega de la información 13 sino que es necesario que el profesional establezca una relación empática y de colaboración con el usuario que le permita sentirse acompañado en el proceso de decidir, como también que utilice las herramientas necesarias para que la información pueda ser comprendida por ellos en función de su edad y nivel educacional 14,15 , variables que en este estudio aparecen asociadas a la presencia de CD. Esto es especialmente relevante en el contexto de enfermedades crónicas, ya que ha sido reportado que el CD se asocia de manera significativa al arrepentimiento de la decisión 16 , hecho que podría afectar la adherencia y por tanto comprometer los resultados clínicos y calidad de vida de los usuarios 17 .…”

Disclosure of cardiac variants of uncertain significance results in an exome cohort

“…Items 2 and 4 were reverse‐coded so that a higher number indicated more regret. The mean score across items was computed and converted to a total score out of 100 with a score of 0 meaning no regret, scores between 0 and 30 interpreted as mild regret, and scores from 30 to 100 interpreted as moderate to high regret …”

“…The mean score across items was computed and converted to a total score out of 100 with a score of 0 meaning no regret, scores between 0 and 30 interpreted as mild regret, and scores from 30 to 100 interpreted as moderate to high regret. 31 Participants were asked 3 open-ended questions to assess their understanding of VUS, if and how the result was shared with family members, and the ways in which they were satisfied and dissatisfied with the result disclosure process. Eighty percent of the participants in this study were white and had at least a college education.…”