Shared Decision-Making and Patient Satisfaction

As the concept of involving patient’s more in decisions about their health care, and respecting their personal preferences, spreads, research into the effect of these practices is increasing.  You would expect that at a minimum patient satisfaction would increase and that is what a recent paper presented to the American Academy of Orthopedic Surgeons suggests.   (AAOS Paper)   About 550 patients with hip or knee osteoarthritis, lumbar spinal stenosis or a lower back slipped or ruptured disk were surveyed.   The average age was around 64, 92% were white, 53% were female, and 63% had college degrees.At the start of the study the survey asked about the patients knowledge of their condition, baseline quality of life, level of pain, ability to move and preferred treatment, whether surgical or some other option.  About half the patients underwent surgery within 6 months of their initial visit.

The patients were followed up six months after an initial visit for those who did not have surgery and six months after surgery for those who did.  These surveys also asked about quality of life and about any regrets regarding treatment choice and treatment outcomes.  About a third of the patients were deemed to have made informed, patient-centered decisions regarding treatment.  This group of patients had much higher scores on condition-specific and overall quality of life measures.  They also had less regret about treatment choice, 5% versus 15% for less informed patients.  They were also more likely to be very or extremely satisfied with their treatment, 71% versus 35%; and to be very satisfied with pain management, 77% versus 42%.  These outcomes indicate that having patients more involved with their health care decisions can lead to better quality.