Can patients' preferences for involvement in decision-making regarding the use of medicines be predicted?
OBJECTIVE
The current study aimed to develop a model of patients' preferences for involvement in decision-making concerning the use of medicines for chronic conditions in the UK and test it in a large representative sample of patients with one of two clinical conditions.


METHODS
Following a structured literature review, an instrument was developed which measured the variables that had been identified as predictors of patients' preferences for involvement in decision making in previous research. Five hundred and sixteen patients with rheumatoid arthritis or type 2 diabetes were recruited from outpatient and primary care clinics and asked to complete the instrument.


RESULTS
Multivariate analysis revealed that age, social class and clinical condition were associated with preferences for involvement in decision-making concerning the use of medicines for chronic illness but gender, ethnic group, concerns about medicines, beliefs about necessity of medicines, health status, quality of life and time since diagnosis were not. In total, the fitted model explained only 14% of the variance.


CONCLUSIONS
This study has demonstrated that current research does not provide a basis for predicting patients' preferences for involvement in decision-making.


CONCLUSIONS
Building concordant relationships may depend on practitioners developing strategies to establish individuals' preferences for involvement in decision-making as part of the ongoing prescriber-patient relationship.
Garfield
S
S
The School of Pharmacy, University of London, London, UK. sara.garfield@pharmacy.ac.uk
Smith
F
F
Francis
S A
SA
Chalmers
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000523:psychology; D002908:Chronic Disease / Q000523:psychology; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology; D004358:Drug Therapy / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom