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Researchers Find Low Level of Patient Involvement in Medical Decision-Making in Peru
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Mayo Clinic and Cayetano Heredia Peruvian University researchers have partnered on a study showing that Peruvian physicians rarely sought to involve their patients in shared decision-making regarding medical care. This was true for physicians at public and private clinics. The findings are being discussed in Lima, Peru, at ISDM 2013, an international conference on globalizing shared decision-making held from June 16-19. (Follow the proceedings and participate in discussion at ISDM 2013.)
MULTIMEDIA ALERT: English and Spanish video of Dr. Montori is available on the Mayo Clinic News Network.
"Some evidence suggests involving patients in decisions decreases conflicts, increases patient satisfaction, and improves their knowledge and short-term adherence to care plans," says study co-author Victor Montori, M.D., of the Mayo Clinic Center for the Science of Health Care Delivery. "For these reasons, patient participation has been expanding, particularly in some health care systems in the Northern Hemisphere."
The researchers recommend further exploration to understand patient involvement in decision-making in emerging health care systems in the Southern Hemisphere.
In the study, researchers observed seven Peruvian physicians who were videotaped in a public or private setting while providing care to patients with chronic conditions. Fifty-eight patients were randomly selected to participate but did not know the purpose of the filming. The physicians were asked to perform medical appointments as usual and were informed that the videotaping would be used to analyze aspects of the physician-patient relationship.
The physicians' effort to involve patients in decision-making was rated on a 100-point scale; the mean score was 14.3.
"Without patient involvement, it won't be possible to place the patient in the center of medical care," says co-author Germán Málaga, M.D., an associate investigator at Cayetano Heredia Peruvian University. "This study offers preliminary evidence of a major flaw of health care systems in which the patient-centered care model is overlooked."
Researchers say these results are preliminary and should be re-evaluated with more patients and physicians. However, if the findings are confirmed, study authors suggest that doctors and patients should rethink the way they interact with one other.
