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A Questionnaire-Based Study to Investigate the Extent of Shared Decision-making During Consultations in Out-of-hours Primary Care

  • Samuel FinnikinEmail author
  • Joanne Protheroe
  • Daniel Lasserson
Concise Research Report

INTRODUCTION

Out-of-hours (OOH) primary care physicians (PCPs) provide urgent primary care when in-hours practices are closed. During consultations, several decisions may be made about treatments, investigations or referral. In modern healthcare systems, there is growing emphasis on involving patients in decisions about their care. It is generally agreed that this should be achieved through the process of ‘shared decision-making’ (SDM). It is also understood that patients vary in their preferences for involvement in decision-making.1

In OOH care, the patient and clinician are not known to one another, there are little or no medical records and patients tend to present with acute problems. These factors mean there is no pre-existing relationship or implicit knowledge in the encounter which increases the necessity for eliciting and incorporating values and preferences into the consultation through a SDM approach. It is not known currently whether decisions being made in an OOH setting...

Notes

Acknowledgements

This study would not have been possible without the support of the clinicians and directors of Badger Group.

Author Contributions

SF DL and JP were involved in the design of the study. SF undertook data collection and analysis and all authors contributed and approved the final manuscript.

Funding Information

This study was unfunded but we acknowledge the support of the West Midlands Clinical Research Network who funded the work required facilitate this research.

Compliance with Ethical Standards

Ethical approval was received from the Proportionate Review Sub-committee of the London Queen Square Research Ethics Committee (REC ref 18/LO/1425).

Conflict of Interest

SF receives income from freelance writing, lecturing and reviewing from a variety of sources including EBSCO Information Services who produce Option Grid™ decision aids.

References

  1. 1.
    Kiesler DJ, Auerbach SM. Optimal matches of patient preferences for information, decision-making and interpersonal behavior: evidence, models and interventions. Patient Educ Couns 2006;61(3):319-41.CrossRefGoogle Scholar
  2. 2.
    Couët N, Desroches S, Robitaille H, Vaillancourt H, Leblanc A, Turcotte S, et al. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument. Health Expect 2015;18(4):542-61.CrossRefGoogle Scholar
  3. 3.
    Degner LF, Sloan JA. Decision making during serious illness: what role do patients really want to play? J Clin Epidemiol 1992;45(9):941-50.CrossRefGoogle Scholar
  4. 4.
    Elwyn G, Barr PJ, Grande SW, Thompson R, Walsh T, Ozanne EM. Developing CollaboRATE: a fast and frugal patient-reported measure of shared decision making in clinical encounters. Patient Educ Couns 2013;93(1):102-7.CrossRefGoogle Scholar
  5. 5.
    Barr PJ, Forcino RC, Thompson R, Ozanne EM, Arend R, Castaldo MG, et al. Evaluating CollaboRATE in a clinical setting: analysis of mode effects on scores, response rates and costs of data collection. BMJ Open 2017;7(3):e014681.CrossRefGoogle Scholar
  6. 6.
    Forcino RC, Barr PJ, O’Malley AJ, Arend R, Castaldo MG, Ozanne EM, et al. Using CollaboRATE, a brief patient-reported measure of shared decision making: Results from three clinical settings in the United States. Health Expect 2018;21(1):82-9.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Institute of Applied Health Research University of BirminghamBirminghamUK
  2. 2.School of Primary, Community and Social CareKeele UniversityKeeleUK
  3. 3.Dept of Acute Medicine, City HospitalSandwell and West Birmingham HospitalsBirminghamUK

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