Physicians' shared decision-making behaviors in depression care.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Clinical Psychology

Background:

• Shared decision making (SDM) is linked to improved quality of care.
• Limited research exists on SDM implementation and influencing factors in primary care settings.
• This study focuses on SDM behaviors in primary care for depression treatment.

Purpose of the Study:

• To assess the extent of physician SDM behaviors in primary care for depression.
• To identify factors associated with physician SDM behaviors in this context.

Main Methods:

• Secondary analysis of a randomized experiment involving 287 audiorecorded physician-standardized patient interactions.
• Utilized the Observing Patient Involvement (OPTION) system to code physician SDM behaviors.
• Employed generalized linear mixed models to analyze physician and patient characteristics associated with SDM behavior.

Main Results:

• Physicians scored an average of 11.4 (SD=3.3) out of 48 on the OPTION scale, indicating low SDM behavior.
• Older physicians and those in health maintenance organizations exhibited fewer SDM behaviors.
• Longer visit durations and patient requests for medication (general or brand-specific) were associated with increased physician SDM behaviors.

Conclusions:

• Primary care physicians demonstrated limited SDM behaviors during new visits for depressive symptoms.
• Practice setting and patient-initiated medication requests significantly influence physician SDM behaviors.
• Further research is required to develop interventions promoting SDM in primary care for depression.