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Patient-physician agreement on the content of CHD prevention discussions
| Content Provider | Scilit |
|---|---|
| Author | Behrend, Lindy Maymani, Hossein Diehl, Megan Gizlice, Ziya Cai, Jianwen Sheridan, Stacey L. |
| Copyright Year | 2010 |
| Description | Journal: Health Expectations Little is known about agreement between patients and physicians on content and outcomes of clinical discussions. A common perception of content and outcomes may be desirable to optimize decision making and clinical care. To determine patient-physician agreement on content and outcomes of coronary heart disease (CHD) prevention discussions. Cross-sectional survey nested within a randomized CHD prevention study. University internal medicine clinic; 24 physicians and 157 patients. Following one clinic visit, we surveyed patients and physicians on discussion content, decision making and final decisions about CHD prevention. For comparison, we audio-recorded, transcribed and coded 20 patient-physician visits. We calculated percent agreement between patient/physician reports, patient/transcription reports and physician/transcription reports. We calculated Cohen's kappas to compare patient/physician perspectives. Patients and physicians agreed on whether CHD was discussed in 130 visits (83%; kappa = 0.55; 95% CI 0.40-0.70). When discussions occurred, they agreed about discussion content (pros versus cons) in 53% of visits (kappa = 0.15; 95% CI -0.01-0.30) and physicians' recommendations in 73% (kappa = 0.44; 95% CI 0.28-0.66). Patients and physicians agreed on final decisions to take medication in 78% (kappa = 0.58; 95% CI 0.45-0.71) and change lifestyle in 69% (kappa = 0.38; 95% CI 0.24-0.53). They agreed less often, 43% (kappa = 0.13; 95% CI -0.11-0.37) about degree of involvement in decision making. Audio-recorded results were similar, but showed very low agreement between transcripts and patients' and physicians' self-report on discussion content and decision making. Disagreements about clinical discussions and decision making may be common. Future work is needed to determine: how widespread such agreements are; whether they impact clinical outcomes; and the relative importance of the subjective experience versus objective steps of shared decision making. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043219/pdf http://onlinelibrary.wiley.com/doi/10.1111/j.1369-7625.2010.00614.x/pdf |
| Ending Page | 72 |
| Page Count | 15 |
| Starting Page | 58 |
| e-ISSN | 13697625 |
| DOI | 10.1111/j.1369-7625.2010.00614.x |
| Journal | Health Expectations |
| Volume Number | 14 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2010-07-27 |
| Access Restriction | Open |
| Subject Keyword | Journal: Health Expectations Social Sciences, Interdisciplinary Patient–physician Agreement Shared Decision Making |
| Content Type | Text |
| Resource Type | Article |
