Article
Antihypertensive Therapy: Is a Shared Decision Making Approach more Effective?
Antihypertensive Therapie: Ist die partnerschaftliche Entscheidungsfindung effektiver?
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Authors
Published: | November 11, 2004 |
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Outline
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Introduction
Lack of adherence is leading to poor control of blood pressure. We tested the hypothesis that shared decision making (SDM) results in higher involvement of patients in therapy and greater treatment satisfaction.
Methods
The intervention group consisted of 16 physicians in a primary care setting taking care of 71 hypertensive patients. The control group consisted of 44 hypertensive subjects. In the intervention group physicians took part in a communication training focusing on the introduction of SDM. In the intervention group 6 SDM-consultations (V1-V6) took place within two years. Questionnaires about the autonomy preference, SDM, quality of life (SF-36), the physician-patient relationship and the primary objective change of blood pressure were analysed.
Results
Physicians and study patients had the opinion to practice more SDM after training (patients: V0 to V1: 89,5 to 93,4; p = 0,03). The more SDM the patients practiced the more increased their satisfaction with the consultations (V2: r = 0,61; p < 0,0001). The physicians´ satisfaction with their consultations decreased the more SDM they practiced (V2: r = - 0,37; p = 0,05), but the physician-patient-relationship from V0 to V3 from physicians´ view improved (V0 to V3: 50,6 to 54; p = 0,04).
Conclusion
The interventions promoted SDM. The more SDM was practiced, the greater the satisfaction with the consultations at the patients´ but not at the physicians´ side was. Further analyses of the disparate effects after practicing SDM will be done.