Shared decision making in out-of-hours general practice V1.0
Research type
Research Study
Full title
A questionnaire based study to investigate the extent of shared decision making during consultations in out-of-hours general practice
IRAS ID
246190
Contact name
Samuel Finnikin
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
This study will investigate the degree of patient involvement in decision making during consultations in out-of-hours general practice. There are over 3 million consultations that take place in an out-of-hours treatment centre every year. In these consultations, acutely unwell patients are seen by general practitioners or advanced nurse practitioners who are not usually know to the patient and who do not have access to the patient's medical record. During these consultations decisions are made regarding treatments and whether patients require further investigations or treatment in hospital.
It is generally agreed that, when making decisions about medical care, patients should be included in the decision making process. This is called 'shared decision making'. However, it is not known to what degree decisions in out-of-hours primary care are being shared with patients. This research will ask patients to what degree they felt involved in decisions about their care immediately after they have had a consultation with an out-of-hours practitioner using a questionnaire designed and tested to quantify patient involvement in decisions.
Lay summary of study results: This questionnaire based study set out to establish to what extent patients felt they were involved in decision making when they were seen in out-of-hours general practice.147 patients were approached immediately after their consultation with a clinician in the out-of-hours clinic and invited to complete a short questionnaire on their encounter. The questionnaire included a trusted measure of shared decision making called CollaboRATE and a measure of patients' preference for involvement in decision making called the Control Preference Scale. 120 questionnaires were completed.
Most patients expressed a strong preference to be involved in decisions about their health, although some preferred a more passive approach. Although there was a relatively high level of shared decision making reported by participants, those who preferred to be more involved with decision making reported lower levels of shared decision making.
This study was the first to look at patient involvement in decision making in this setting and although there was some suggestion that shared decision making was present, there was evidence that more efforts could be made to involve patients in decision making. The study also highlighted the importance of asking patients there preferences for involvement in decision making when measuring shared decision making in practice.
REC name
London - Queen Square Research Ethics Committee
REC reference
18/LO/1425
Date of REC Opinion
3 Aug 2018
REC opinion
Favourable Opinion