The Impact of Physician Attitudes and Beliefs on Treatment Decisions

Foley, Kathleen A.; Denke, Margo A.; Kamal-Bahl, Sachin; Simpson, Ross J.; Berra, Kathy; Sajjan, Shiva; Alexander, Charles M.

doi:10.1097/01.mlr.0000208017.18278.1a

Cited by 25 publications

(18 citation statements)

References 24 publications

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“…Additionally, our findings corroborate research indicating that situational factors, such as clinical scenarios and the urgency of decision making, influence SDM [32]. Finally, studies have shown that physician attitudes and beliefs determine translation of guidelines into clinical practice [33]; we found similar results in our study regarding HU and BMT.…”

Section: Discussionsupporting

confidence: 90%

Proponent or collaborative: Physician perspectives and approaches to disease modifying therapies in sickle cell disease

et al. 2017

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Sickle cell disease (SCD) is an inherited blood disorder that primarily affects African-American and other ethnic minority populations. There are three available disease-modifying therapies for sickle cell disease: hydroxyurea (HU), bone marrow transplantation (BMT), and chronic blood transfusion (CBT). Since these treatments vary in their therapeutic intent, efficacy in preventing progression of the disease, short and long-term adverse effects, costs and patient burden, the decision-making process regarding these therapies is complicated for both the patient and healthcare provider. While previous research has focused on the patient perspective of treatment-related decision making, there is a paucity of research investigating the physician perspective of treatment-related decision making. We conducted a qualitative study with physicians who were experts in the field of SCD. Interviews focused on physician perceptions of patient decisional needs as well as physicians’ approach to decision making regarding disease-modifying therapies in SCD. Thirty-six physician interviews were analyzed, with a focus on their perspectives regarding available treatment options and on how they approach decision making with patients. We identified two narrative approaches. The Collaborative approach (CA) was characterized by emphasizing the need to discuss all possible treatment options to ensure that the patient and/or family was equipped to make an informed decision. The Proponent approach (PA) was characterized by strongly advocating a pre-determined treatment plan and providing patients/families with information, with the objective of convincing them to accept the treatment. An interplay of patient-related and disease-related factors, decision type and physician-related factors, as well as institutional frameworks, influenced physician perspectives on treatment options and decision making regarding these therapies. These findings point to the potential value of developing systems to foster patient engagement as a way of facilitating shared decision making.

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Section: Discussionsupporting

confidence: 90%

Proponent or collaborative: Physician perspectives and approaches to disease modifying therapies in sickle cell disease

et al. 2017

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“…Relatively few patients received lipid-lowering medication, and intensification of such medication was uncommon. As was shown in other studies, GPs may have several reservations for prescribing lipid-lowering medication, such as expecting very few benefits in older patients or in patients with near-goal lipid levels 34 35. Also, patients can be reluctant to take them.…”

Section: Discussionmentioning

confidence: 95%

Cardiometabolic treatment decisions in patients with type 2 diabetes: the role of repeated measurements and medication burden

Voorham

Haaijer‐Ruskamp²,

Wolffenbuttel

et al. 2010

BMJ Quality & Safety

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“…studied the impact of physician attitudes and beliefs on treatment decisions for lipid therapy in high‐risk patients and found that patients whose physicians believed ‘close enough to goal is good enough’ had 47% lower odds of receiving increases in statin dose (odds ratio, 0.53; confidence interval, 0.34–0.82). In comparison, patients whose physicians believed ‘statins are effective’ had almost twice the odds of having a dose increase (19). Our findings were in contradiction to these; no correlation between attitudes and self‐stated use of the therapies was found.…”

Section: Discussionmentioning

confidence: 99%

Unperceived treatment gaps in acute coronary syndromes

Huynh¹,

Chew²,

Sladek³

et al. 2009

International Journal of Clinical Practice

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The Impact of Physician Attitudes and Beliefs on Treatment Decisions

Abstract: Although the understanding of basic and clinical science remains fundamental, clinical guideline authors may want to consider the importance of physician attitudes and beliefs in determining translation of their guidelines into clinical practice.

Cited by 25 publications

References 24 publications

Proponent or collaborative: Physician perspectives and approaches to disease modifying therapies in sickle cell disease

Proponent or collaborative: Physician perspectives and approaches to disease modifying therapies in sickle cell disease

Cardiometabolic treatment decisions in patients with type 2 diabetes: the role of repeated measurements and medication burden

Unperceived treatment gaps in acute coronary syndromes

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