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Patient Satisfaction And Decision Making Quality Greatly Improved During Improved Medical Consultations, UCSF Researchers Report

combine evidence-and preference-based medicine to maximize treatment decision quality. They also enhanced patient-physician communication and collaborative decision-making, elements that have been linked to improved patient outcomes and treatment compliance.

During the pilot study, 24 breast cancer patients facing treatment decisions were divided into a control and intervention group (12 women in each arm). Both patient groups participated in a medical consultation session. In the intervention group, a trained facilitator created and implemented a meeting agenda, and facilitated and recorded the consultation. In the control group, a trained facilitator only observed the consultation.

Using a scale of 1-20 (20 as the highest score), women in the intervention group reported a significantly higher final decision quality compared to those in the control group (median score 14 versus 10); an improvement in overall decision quality (median score 9.7 versus 6.6); and higher satisfaction with their medical consultation (median score 11 versus 7).

Further, patients and physicians in the intervention group achieved a significantly higher level of agreement about decision quality compared to those in the control group.

A patient's decision quality was defined as the level of understanding she has of her diagnosis, treatment options and their risks and benefits, personal preferences and comfort with final decisions.

"As critical decision making has transferred to the outpatient setting and patients desire more participation in the process, better tools to elicit patient preferences and describe treatment options are needed," Esserman says.

"Our next step is to propose a more extensive study where we will test consultation recording and facilitation mechanisms in a larger group of patients and physicians."

The study was funded in part by the U.S. Department of Defense (DOD) and the Arthur Vining Davis Foundation. Other authors of the study includ
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Contact: Abby Sinnot
asinnot@pubaff.ucsf.edu
415-885-7277
University of California - San Francisco
17-May-1999


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