title: A shared decision-making communication training program for physicians treating fibromyalgia patients: effects of a randomized controlled trial.
abstract: OBJECTIVE
  Fibromyalgia syndrome (FMS) is a condition of chronic widespread pain that is difficult to control and is associated with strains in physician-patient interaction. Shared decision making (SDM) can be a potential solution to improve interaction. We evaluated the effects of an SDM intervention, including an SDM communication training program for physicians, in a randomized controlled trial with FMS patients. The main objective was to assess whether SDM improves the quality of physician-patient interaction from patients' perspective.
  
  
  METHODS
  Patients were randomized to either an SDM group or an information-only group. The SDM group was treated by physicians trained in SDM communication and had access to a computer-based information package; the information-only group received only the information package and was treated by standard physicians. All patients were offered the same evidence-based treatment options for FMS. Patients were assessed with questionnaires on physician-patient interaction (main outcome criteria) and decisional processes. Physicians filled out a questionnaire on interaction difficulties. Assessment took place immediately after the initial consultation.
  
  
  RESULTS
  Data from 85 FMS patients (44 in the SDM group and 41 in the information-only group) were analyzed. The mean age was 49.9 years (S.D.=10.2), and 91.8% of patients were female. The quality of physician-patient interaction was significantly higher in the SDM group than in the information-only group (P<.001). We found no differences in secondary outcome measures.
  
  
  CONCLUSIONS
  SDM with FMS patients might be a possible means to achieve a positive quality of physician-patient interaction. A specific SDM communication training program teaches physicians to perform SDM and reduces frustration in patients.
authors.affiliation: Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Heidelberg, Germany. christiane.bieber@med.uni-heidelberg.de <christiane.bieber@med.uni-heidelberg.de>
authors.forename: Christiane
authors.initials: C
authors.lastname: Bieber
authors.forename: Knut Georg
authors.initials: KG
authors.lastname: Müller
authors.forename: Klaus
authors.initials: K
authors.lastname: Blumenstiel
authors.forename: Achim
authors.initials: A
authors.lastname: Hochlehnert
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wilke
authors.forename: Mechthild
authors.initials: M
authors.lastname: Hartmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eich
mesh_terms: D000328:Adult; D003142:Communication; D003657:Decision Making; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000628:therapy*