Three questions that patients can ask to improve the quality of information physicians give about treatment options: a cross-over trial

Heather L. Shepherd, Alexandra Barratt, Lyndal J. Trevena, Kevin McGeechan, Karen Carey, Ronald M. Epstein, Phyllis N. Butow, Chris B. Del Mare, Vikki Entwistle, Martin H. N. Tattersall

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    96 Citations (Scopus)

    Abstract

    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.

    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.

    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 < 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.

    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.

    Original languageEnglish
    Pages (from-to)379-385
    Number of pages7
    JournalPatient Education and Counseling
    Volume84
    Issue number3
    DOIs
    Publication statusPublished - Sep 2011

    Keywords

    • Doctor-patient communication
    • Standardized patients
    • Patient involvement
    • Treatment decision-making
    • Evidence-based medicine
    • Primary care
    • SHARED DECISION-MAKING
    • RANDOMIZED CONTROLLED-TRIAL
    • UNANNOUNCED STANDARDIZED PATIENTS
    • PRIMARY-CARE
    • GENERAL-PRACTICE
    • CANCER CONSULTATION
    • PROMPT LIST
    • HEALTH-CARE
    • DEPRESSION
    • PARTICIPATION

    Cite this

    Shepherd, H. L., Barratt, A., Trevena, L. J., McGeechan, K., Carey, K., Epstein, R. M., Butow, P. N., Del Mare, C. B., Entwistle, V., & Tattersall, M. H. N. (2011). Three questions that patients can ask to improve the quality of information physicians give about treatment options: a cross-over trial. Patient Education and Counseling, 84(3), 379-385. https://doi.org/10.1016/j.pec.2011.07.022