Shared decision-making boosts trust in physicians among patients with lupus
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Key takeaways:
- Shared decision-making increased trust in physicians among patients with systemic lupus erythematosus.
- Shared decision-making is key to ensuring confidence where treatment uncertainties exist, the researchers wrote.
Practicing shared decision-making increases overall trust in health care providers among patients with systemic lupus erythematosus, according to data published in Arthritis Care & Research.
“[Shared decision-making (SDM)] is expected to aid patients with SLE whose treatment regimen requires modification during each period of exacerbation and remission to achieve treatment goals,” Ryusuke Yoshimi, MD, PhD, of the Yokohama City University Graduate School of Medicine, in Japan, and colleagues wrote. “However, few empirical studies have examined the pathway to the achievement of treatment goals.
“For instance, it is generally still largely unexplored whether an increase in patient satisfaction due to high-quality SDM ultimately leads to increased trust in physicians and adherence to physicians’ recommendations, and this is particularly the case in patients with SLE,” they added. “Trust in physicians is central to medical care, as it aids in maintaining medication adherence among patients with SLE.”
To examine the effect of shared decision-making on physician trust in patients with SLE, Yoshimi and colleagues conducted a prospective cohort study using data from the TRUMP2-SLE project. The analysis included 433 adults with SLE (mean age, 46.8 years), most of whom had been followed by the attending physicians for 3 years or longer. Levels of shared decision-making and physician trust were measured using self-reported questionnaires.
The primary outcome — trust in the attending rheumatologist — was assessed using a modified 11-item Trust in Physician Scale (TIPS). A secondary outcome — trust in the attending physician and in physicians in general — was assessed using the Japanese version of the Abbreviated Wake Forest Physician Trust Scale (A-WFPTS). Relationships between questionnaire scores were analyzed using general linear models, with cluster-robust estimation to “address the clustering of outcomes resulting from multiple patient ratings with similar trust levels for the same rheumatologist,” the researchers wrote.
At 1 year, higher baseline SDM-Q-9 scores were correlated with increases in both the TIPS score (coefficient per 10-point increase: 0.94; 95% CI, 0.16-1.72) and A-WFPTS score (coefficient per 10-point increase: 2.2; 95% CI, 1.44-2.96), according to the researchers. Higher scores on SDM-Q-9 were also linked with increased scores on the general physician version of the A-WFPTS questionnaire at 1 year (coefficient per 10-point increase: 1.29; 95% CI, 0.41-2.18).
“The present study demonstrated, for the first time, that greater involvement of patients with SLE in SDM contributes to the subsequent formation of trust in their attending rheumatologists and general physicians,” Yoshimi and colleagues wrote.
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