Three questions that patients can ask to improve the quality of information physicians give about treatment options: a cross-over trial

Heather L. Shepherd, University of Sydney
Alexandra Barratt, University of Sydney
Lyndal J. Trevena, University of Sydney
Kevin McGeechan, University of Sydney
Karen Carey, Consumers Health Forum
Ronald M. Epstein, University of Rochester
Phyllis N. Butow, University of Sydney
Chris Del Mar, Bond University
Vikki Entwistle, University of Dundee
Martin H.N. Tattersall, University of Sydney

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Shepherd, H. L., Barratt, A., Trevena, L. J., McGeechan, K., et al. (2011). Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient education and counseling, 84 (3), 379-385.

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2011 HERDC submission. FoR code: 111717

© Copyright Elsevier Ireland Ltd., 2011. All rights reserved.

Abstract

Objective:
To test the effect of three questions (what are my options? what are the benefits and harms? and how likely are these?), on information provided by physicians about treatment options.

Methods:
We used a cross-over trial using two unannounced standardized patients (SPs) simulating a presentation of mild-moderate depression. One SP was assigned the intervention role (asking the questions), the other the control role. An intervention and control SP visited each physician, order allocated randomly. The study was conducted in family practices in Sydney, Australia, during 2008–09. Data were obtained from consultation audio-recordings. Information about treatment options and patient involvement were analyzed using the Assessing Communication about Evidence and Patient Preferences (ACEPP) tool and the OPTION tool.

Results:
Thirty-six SP visits were completed (18 intervention, 18 control). Scores were higher in intervention consultations than controls: ACEPP scores 21.4 vs. 16.6, p < 0.001, difference 4.7 (95% CI 2.3–7.0) and OPTION scores 36 vs. 25, p = 0.001, difference 11.5 (95% CI 5.1–17.8), indicating greater information provision and behavior supporting patient involvement.

Conclusion:
Asking these three questions improved information given by family physicians and increased physician facilitation of patient involvement. Practice implications. These questions can drive evidence-based practice, strengthen patient–physician communication, and improve safety and quality.