Three questions that patients can ask to improve the quality of information physicians give about treatment options

TY - JOUR

T1 - Three questions that patients can ask to improve the quality of information physicians give about treatment options

T2 - a cross-over trial

A1 - Shepherd,Heather L.

A1 - Barratt,Alexandra

A1 - Trevena,Lyndal J.

A1 - McGeechan,Kevin

A1 - Carey,Karen

A1 - Epstein,Ronald M.

A1 - Butow,Phyllis N.

A1 - Del Mare,Chris B.

A1 - Entwistle,Vikki

A1 - Tattersall,Martin H. N.

AU - Shepherd,Heather L.

AU - Barratt,Alexandra

AU - Trevena,Lyndal J.

AU - McGeechan,Kevin

AU - Carey,Karen

AU - Epstein,Ronald M.

AU - Butow,Phyllis N.

AU - Del Mare,Chris B.

AU - Entwistle,Vikki

AU - Tattersall,Martin H. N.

PY - 2011/9

Y1 - 2011/9

N2 - <p>Objective: To test the effect of three questions (what are my options? what are the benefits and harms? and how likely are these?), on information provided by physicians about treatment options.</p><p>Methods: We used a cross-over trial using two unannounced standardized patients (SPs) simulating a presentation of mild-moderate depression. One SP was assigned the intervention role (asking the questions), the other the control role. An intervention and control SP visited each physician, order allocated randomly. The study was conducted in family practices in Sydney. Australia, during 2008-09. Data were obtained from consultation audio-recordings. Information about treatment options and patient involvement were analyzed using the Assessing Communication about Evidence and Patient Preferences (ACEPP) tool and the OPTION tool.</p><p>Results: Thirty-six SP visits were completed (18 intervention, 18 control). Scores were higher in intervention consultations than controls: ACEPP scores 21.4 vs. 16.6, p &lt; 0.001, difference 4.7 (95% CI 2.3-7.0) and OPTION scores 36 vs. 25, p = 0.001, difference 11.5 (95% CI 5.1-17.8), indicating greater information provision and behavior supporting patient involvement.</p><p>Conclusion: Asking these three questions improved information given by family physicians and increased physician facilitation of patient involvement. Practice implications. These questions can drive evidence-based practice, strengthen patient-physician communication, and improve safety and quality. (C) 2011 Elsevier Ireland Ltd. All rights reserved.</p>

AB - <p>Objective: To test the effect of three questions (what are my options? what are the benefits and harms? and how likely are these?), on information provided by physicians about treatment options.</p><p>Methods: We used a cross-over trial using two unannounced standardized patients (SPs) simulating a presentation of mild-moderate depression. One SP was assigned the intervention role (asking the questions), the other the control role. An intervention and control SP visited each physician, order allocated randomly. The study was conducted in family practices in Sydney. Australia, during 2008-09. Data were obtained from consultation audio-recordings. Information about treatment options and patient involvement were analyzed using the Assessing Communication about Evidence and Patient Preferences (ACEPP) tool and the OPTION tool.</p><p>Results: Thirty-six SP visits were completed (18 intervention, 18 control). Scores were higher in intervention consultations than controls: ACEPP scores 21.4 vs. 16.6, p &lt; 0.001, difference 4.7 (95% CI 2.3-7.0) and OPTION scores 36 vs. 25, p = 0.001, difference 11.5 (95% CI 5.1-17.8), indicating greater information provision and behavior supporting patient involvement.</p><p>Conclusion: Asking these three questions improved information given by family physicians and increased physician facilitation of patient involvement. Practice implications. These questions can drive evidence-based practice, strengthen patient-physician communication, and improve safety and quality. (C) 2011 Elsevier Ireland Ltd. All rights reserved.</p>

KW - Doctor-patient communication

KW - Standardized patients

KW - Patient involvement

KW - Treatment decision-making

KW - Evidence-based medicine

KW - Primary care

KW - SHARED DECISION-MAKING

KW - RANDOMIZED CONTROLLED-TRIAL

KW - UNANNOUNCED STANDARDIZED PATIENTS

KW - PRIMARY-CARE

KW - GENERAL-PRACTICE

KW - CANCER CONSULTATION

KW - PROMPT LIST

KW - HEALTH-CARE

KW - DEPRESSION

KW - PARTICIPATION

UR - http://www.scopus.com/inward/record.url?partnerID=yv4JPVwI&eid=2-s2.0-80051774072&md5=91b9d8d10ab56ae7334fa4665c27e6e5

U2 - 10.1016/j.pec.2011.07.022

DO - 10.1016/j.pec.2011.07.022

M1 - Article

JO - Patient Education and Counseling

JF - Patient Education and Counseling

SN - 0738-3991

IS - 3

VL - 84

SP - 379

EP - 385

ER -