There is some evidence that outcomes improve when patients are involved
in shared decision making [collaborating with providers on healthcare
decisions]. A chronic pain clinic or premedication visit can be adequate
settings for the implementation of this process. A group of chronic
pain patients was compared with a group of patients in the premedication
visit with respect to shared decision making (SDM), the desire for information
and perceived involvement in care. The autonomy preference index (API,
measuring preference for involvement and desire for information) and
the perceived involvement in care scale (PICS, measuring patients' perception
of easier involvement by doctors and information exchange) were administered.
In total, 190 chronic pain patients and 151 patients in the premedication
visit were included in this study. Premedication visit patients had
significantly higher SDM scores. Desire for information was high, but
there were no differences between the groups. Younger patients, women,
and patients with higher educational level had more desire for SDM.
Chronic pain patients felt more facilitated by doctors and had more
information exchange than patients in the premedication visit. The desire
for information was high in both groups, but patients in the premedication
visit had higher SDM scores, especially young female patients with higher
educational level. Real patient-physician interaction showed that premedication
patients felt less involved by doctors and had less information exchange
compared with the chronic pain patients. The investigators agree that
on premedication visits, providers should focus more on adequate information
exchange and involvement of the patient in the shared decision making
process. Spies CD, Schulz CM, Weiss-Gerlach E, Neuner B, Neumann T,
von Dossow V, Schenk M, Wernecke KD, Elwyn G. Adapted from Acta Anaesthesiol
Scand. 2006 Sep;50(8):1019-1026.
PMID: 16923100
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the National
Library of Medicine (NLM).
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