Patients’ Expectations of the Benefits and Harms of Treatments, Screening, and Tests: A Systematic Review
This paper reports findings of a study to determine whether shared decision making was associated with patient ratings of care quality and physician communication and whether patients’ preferred decision roles modified those associations.
The study found that decisions controlled by doctors regarding lung or colorectal cancer treatment were associated with lower ratings of care quality and physician communication. These effects were independent of patients’ preferred decision roles, underscoring the importance of seeking to involve all patients in decision making about their treatment.
The research found that among patients receiving a treatment under consideration, those reporting doctor-controlled vs shared decisions were less likely to report excellent quality of care for that treatment. This effect was not modified by preferred role in treatment decision making, implying that shared decision making was associated with higher perceived quality, even for patients preferring less active roles in medical decisions. Similarly, patients who reported doctor-controlled decisions gave lower ratings of doctor communication compared with those reporting shared decisions, and patients’ preferred role in decisions did not modify this effect. The authors suggest that providing information to patients with colorectal and lung and engaging them in shared decisions is valuable, even for patients who express preferences for doctors to control the decision-making process.