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

doi:10.1016/j.pec.2011.07.022

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

Research output: Contribution to journal › Article › peer-review

177 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 language	English
Pages (from-to)	379-385
Number of pages	7
Journal	Patient Education and Counseling
Volume	84
Issue number	3
DOIs	https://doi.org/10.1016/j.pec.2011.07.022
Publication status	Published - Sept 2011

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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

Access to Document

10.1016/j.pec.2011.07.022

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

@article{b8b832e81fa4463d974dc8fd70b64e59,

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

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.",

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",

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

note = "Enhancing the patient position in the world of health care: Contributions from the EACH 2010 conference in Verona",

year = "2011",

month = sep,

doi = "10.1016/j.pec.2011.07.022",

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volume = "84",

pages = "379--385",

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Shepherd, HL, Barratt, A, Trevena, LJ, McGeechan, K, Carey, K, Epstein, RM, Butow, PN, Del Mare, CB, Entwistle, V & Tattersall, MHN 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, vol. 84, no. 3, pp. 379-385. https://doi.org/10.1016/j.pec.2011.07.022

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

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.

N1 - Enhancing the patient position in the world of health care: Contributions from the EACH 2010 conference in Verona

PY - 2011/9

Y1 - 2011/9

N2 - 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.

AB - 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.

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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

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U2 - 10.1016/j.pec.2011.07.022

DO - 10.1016/j.pec.2011.07.022

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SN - 0738-3991

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