Related ReferencesEvidence Statements (summary of evidence)
McKinstry (2006) 77One high quality systematic review found that there is insufficient evidence to conclude that any intervention may increase or decrease trust in physicians.
van Dam (2003) 78One systematic review of RCTs found that supporting patient participation in diabetes care and self-care behaviour (i.e. by assistant- guided patient preparation for visits to doctors, empowering group education, group consultations, or automated telephone management) is more effective than changing provider consultation style for improving patient self-care and diabetes outcomes.
Edwards (2004) 79One RCT reported statistically significant effects of the research clinic group (which provided more consultation time) in confidence in decision and expectation to adhere to chosen treatments.
Cohen (2004) 80; Edwards (2004) 79Two studies from the same randomised controlled trial found that training GPs in SDM or combined with risk communication yielded conflicting results in the probability of a prescription being issued to patients.
Cohen (2004) 80; Edwards (2004) 79Two studies from the same randomised controlled trial found that training GPs in SDM or combined with risk communication yielded no effect on the probability of investigations, referrals or follow-up GP visits for any of the conditions.
Savage (1990) 81One RCT found that a directing style of consultation yielded statistically significantly higher levels of satisfaction on almost all the outcome measures compared to a sharing style. This was particularly relevant for patients with physical problems.
Shields (2005) 82One RCT reported a statistically significant likelihood of a physician promoting collaboration in treatment decision-making and exploring issues around the disease and illness with patients rather than with companions of the patients e.g. physicians were more likely to be responsive to being patient-centred when the patient raised the issue than when their companion raised it. There was no difference in level of patient- centeredness between the unaccompanied and accompanied visits.
Shields (2005) 82One RCT reported a statistically significant responsiveness of a physician to explore the disease and illness when the issues were raised by the patient compared with the companion of the patient.

From: 4, Interventions to increase shared decision-making about medicines

Cover of Medicines Adherence
Medicines Adherence: Involving Patients in Decisions About Prescribed Medicines and Supporting Adherence [Internet].
NICE Clinical Guidelines, No. 76.
National Collaborating Centre for Primary Care (UK).
Copyright © 2009, Royal College of General Practitioners.

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