Information giving and involvement in treatment decisions: Is more really better? Psychological effects and relation with adherence

Abstract

Objectives : The aim of this study is to improve our understanding of the ways in which a medical consultation style relates to satisfaction and adherence.

Design : Participants completed questionnaires about preferred and perceived consultation styles; psychological variables such as satisfaction, anxiety and depression; and questions about taking medication. Questionnaires were completed prior to the consultation, immediately after, three months later and one year later. Doctors also completed a scale on completion of the consultation. The decisions in question related to women seeking advice about Hormone Replacement Therapy (HRT) and decisions about pain management.

Results : Patients expressed preferences for information about the treatment options and for active involvement in the decision process. The extent to which patients perceived themselves as having received information about the treatment options was a particularly consistent predictor of satisfaction. The extent to which patients perceived themselves as having been prepared for the side effects of HRT was a consistent predictor of anxiety.

Conclusions : Perceptions of the amount of information received about medical options, including information preparing individuals for potential side effects of medication, appears to be more important to satisfaction and anxiety, than actual involvement in the decision.

Keywords:

• adherence
• decision-making
• consultation style
• satisfaction
• anxiety

Acknowledgements

The research was supported by The Wellcome Trust and the University of Oxford Medical Research Fund. The researchers would like to thank Dr Sally Hope; Pain Clinic team at Churchill Hospital, Oxford; the Obstetrics and Gynaecology team at the John Radcliffe Hospital, Oxford; and Dr Theo Schofield.