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Patient Educ Couns. 2017 Oct;100(10):1910-1917. doi: 10.1016/j.pec.2017.04.020. Epub 2017 May 1.

An evaluation of two interventions to enhance patient-physician communication using the observer OPTION5 measure of shared decision making.

Author information

1
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: dillone@pamfri.org.
2
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: stultsc@pamfri.org.
3
All Native Group, Alexandria, VA, USA. Electronic address: cwilson@allnativegroup.com.
4
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: chuangj@pamfri.org.
5
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: meehana@pamfri.org.
6
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: lim@pamfri.org.
7
The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: glynelwyn@gmail.com.
8
Palo Alto Medical Foundation Research Institute, Mountain View, USA; Department of Medicine, University of California, Los Angeles, USA. Electronic address: froschd@pamfri.org.
9
Palo Alto Medical Foundation, Mountain View, USA. Electronic address: yue2@pamf.org.
10
Palo Alto Medical Foundation Research Institute, Mountain View, USA. Electronic address: tai-sealeM@pamfri.org.

Abstract

OBJECTIVE:

Evaluate interventions to enhance patient-physician communication and shared decision making (SDM).

METHODS:

We used Observer OPTION5 to evaluate primary care visits within a cluster randomized controlled trial in a California delivery organization. Trial interventions included Open Communication (OpenComm), combining patient activation and physician coaching, and AskShareKnow, a patient activation tool, and were compared to a usual care arm. Scores were analyzed with descriptive statistics and generalized estimating equation analysis for 40 visits containing 200 decision topics.

RESULTS:

The mean overall OPTION5 score was 26.5 out of 100 (s.d.=15.2). Compared to visits in the usual care arm, OpenComm visits had higher mean item scores (0-4 scale) for eliciting (mean=1.0 vs 0.8) and integrating patient preferences (mean=1.0 vs 0.8). OpenComm and AskShareKnow visits had higher scores for presenting options (mean=1.5, 1.5 vs 1.3). AskShareKnow visits had higher scores for discussing pros/cons (mean=1.5 vs 1.1). Lower patient education attainment was associated with lower scores.

CONCLUSIONS:

OpenComm and AskShareKnow were associated with improved SDM relative to usual care.

PRACTICE IMPLICATIONS:

Results suggest targeting patient and physician behaviors promotes SDM better than patient activation only. Improving SDM for less educated patients is crucial.

KEYWORDS:

Measurement; Methods; Patient–provider communication; Shared decision making

PMID:
28532861
DOI:
10.1016/j.pec.2017.04.020
[Indexed for MEDLINE]

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