title: [The process of shared decision making in chronic pain patients. Evaluation and modification of treatment decisions].
abstract: Conditions affecting the musculoskeletal system are the cause of approximately 25% of absenteeism from work. Fibromyalgia syndrome is an exemplary condition of chronic widespread pain which most physicians consider difficult to manage. The physician-patient relationship is burdened with resignation and frustration on both sides. Initial agreement regarding the aims of treatment is rare. The patient's active involvement in the decision making process is expected to improve the physician-patient relationship. One aspect of this shared decision making process is the evaluation and possibly modification of treatment decisions. In the present study 39 consultations of physicians who had undergone special communication training were examined as to whether these physicians actually exercised the option of revising their treatment decisions. In 87.2% of the consultations the therapy decisions were modified within three months after the first encounter. Patients considered to be "difficult" were less likely to modify their decisions. The shared decision making process usually takes more than one consultation.
authors.affiliation: Abteilung Innere Medizin II, Allgemeine Klinische und Psychosomatische Medizin, Universitätsklinikum Heidelberg. Knut.Mueller@med.uni-heidelberg.de
authors.forename: Knut Georg
authors.initials: KG
authors.lastname: Müller
authors.forename: Angelika
authors.initials: A
authors.lastname: Richter
authors.forename: Christiane
authors.initials: C
authors.lastname: Bieber
authors.forename: Klaus
authors.initials: K
authors.lastname: Blumenstiel
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wilke
authors.forename: Achim
authors.initials: A
authors.lastname: Hochlehnert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eich
mesh_terms: D002908:Chronic Disease; D006801:Humans; D010146:Pain / Q000523:psychology* / Q000534:rehabilitation; D010358:Patient Participation / Q000523:psychology*; D010817:Physician-Patient Relations