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Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia

OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient prefer...

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Autores principales: Hamann, Johannes, Kissling, Werner, Mendel, Rosmarie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030606/
https://www.ncbi.nlm.nih.gov/pubmed/27638491
http://dx.doi.org/10.1136/bmjopen-2016-011282
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author Hamann, Johannes
Kissling, Werner
Mendel, Rosmarie
author_facet Hamann, Johannes
Kissling, Werner
Mendel, Rosmarie
author_sort Hamann, Johannes
collection PubMed
description OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient preferences. Within the present study we wanted to evaluate at what time in the decision-making process a doctor's recommendation is best given, not to adversely influence patient preferences. DESIGN: We performed an experimental study involving hypothetical decisions vignettes and compared the influence of 3 conditions (no advice, early advice, late advice) on patients' decision-making. SETTING: N=21 psychiatric hospitals in Germany. PARTICIPANTS: N=208 inpatients suffering from schizophrenia. PRIMARY AND SECONDARY OUTCOME MEASURES: The main outcome was the number of patients choosing the option in each experimental condition that had been less preferable to most patients during pretests. Additional outcome measures were patient satisfaction and reactance. RESULTS: Patients in the ‘late advice’ condition more often (n=49) accepted an advice that was against their preferences compared with the other conditions (n=36 for ‘early advice’, p=0.024). CONCLUSIONS: Although giving advice is an important part of every doctor's daily practice and is seen as an essential element of shared decision-making, hitherto there has been little empirical evidence relating to the influence of physicians' advice on patients' decision-making behaviour. With our study we could show that the point in time an advice is given by a physician does have an influence on patients' decisional behaviour even if the mechanism of this effect is not yet understood.
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spelling pubmed-50306062016-10-04 Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia Hamann, Johannes Kissling, Werner Mendel, Rosmarie BMJ Open Patient-Centred Medicine OBJECTIVES: Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient preferences. Within the present study we wanted to evaluate at what time in the decision-making process a doctor's recommendation is best given, not to adversely influence patient preferences. DESIGN: We performed an experimental study involving hypothetical decisions vignettes and compared the influence of 3 conditions (no advice, early advice, late advice) on patients' decision-making. SETTING: N=21 psychiatric hospitals in Germany. PARTICIPANTS: N=208 inpatients suffering from schizophrenia. PRIMARY AND SECONDARY OUTCOME MEASURES: The main outcome was the number of patients choosing the option in each experimental condition that had been less preferable to most patients during pretests. Additional outcome measures were patient satisfaction and reactance. RESULTS: Patients in the ‘late advice’ condition more often (n=49) accepted an advice that was against their preferences compared with the other conditions (n=36 for ‘early advice’, p=0.024). CONCLUSIONS: Although giving advice is an important part of every doctor's daily practice and is seen as an essential element of shared decision-making, hitherto there has been little empirical evidence relating to the influence of physicians' advice on patients' decision-making behaviour. With our study we could show that the point in time an advice is given by a physician does have an influence on patients' decisional behaviour even if the mechanism of this effect is not yet understood. BMJ Publishing Group 2016-09-16 /pmc/articles/PMC5030606/ /pubmed/27638491 http://dx.doi.org/10.1136/bmjopen-2016-011282 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Patient-Centred Medicine
Hamann, Johannes
Kissling, Werner
Mendel, Rosmarie
Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title_full Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title_fullStr Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title_full_unstemmed Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title_short Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia
title_sort does it matter whether physicians' recommendations are given early or late in the decision-making process? an experimental study among patients with schizophrenia
topic Patient-Centred Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030606/
https://www.ncbi.nlm.nih.gov/pubmed/27638491
http://dx.doi.org/10.1136/bmjopen-2016-011282
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