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Quality in Health Care 2001;10: i39-i43
© 2001 Quality in Health Care

II. Patients'and clinicians' preference

How do patients' treatment preferences compare with those of clinicians?

A A Montgomery, MRC health services research training fellow, T Fahey, senior lecturer

Division of Primary Health Care, University of Bristol, Bristol BS8 2PR, UK

Dr A Montgomery alan.a.montgomery{at}bristol.ac.uk Abstract

The shared model of medical decision making has been proposed as the preferred method of determining patients' treatment. However, agreement may be more difficult to achieve if patients' and clinicians' preferences are polarised. The aim of this paper is to explore how closely patients and clinicians agree in their preferences for different treatment options. Only studies that made quantifiable estimates of preferences were included. There is some evidence that patients and health professionals often do not agree on treatment preference in the areas of cardiovascular disease, cancer, obstetrics and gynaecology, and acute respiratory illness. However, the magnitude and direction of these differences vary and may depend on the condition of interest. Most of the research to date is cross sectional; longitudinal research is required to investigate whether preferences change over time and are related to treatment choice, adherence to medication if taken, and health outcomes.

Key Words: patient preference; treatment choice; decision making; patient-caregiver communication




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