Do physicians' recommendations pull patients away from their preferred treatment options?

Area of Science:

• Medical Decision Making
• Patient-Physician Communication
• Health Psychology

Background:

• Shared decision-making is crucial for preference-sensitive health choices.
• Physician recommendations may influence patient choices, potentially overriding patient preferences.

Purpose of the Study:

• To investigate if physician recommendations influence patient decisions away from their stated preferences in preference-sensitive scenarios.
• To assess patient satisfaction with decisions made under physician influence.

Main Methods:

• Inpatients with schizophrenia (N=102) and multiple sclerosis (N=101) were presented with a hypothetical drug choice scenario.
• Participants stated preferences, received a contrary physician recommendation, and then made a final choice.
• The primary outcome was whether patients followed the physician's advice, with pre-recommendation preferences as baseline.

Main Results:

• Approximately 48% of schizophrenia patients and 26% of multiple sclerosis patients followed physician advice against their initial preferences.
• Patients who followed physician advice reported significantly lower satisfaction with their decision compared to those who did not.
• Statistical significance was observed for both patient groups (schizophrenia: P = 0.01; multiple sclerosis: P = 0.009).

Conclusions:

• Physician advice can significantly influence patient choices in preference-sensitive decisions, potentially leading them away from their preferred options.
• Physicians should be mindful of their influence and actively support patients in identifying and aligning choices with their preferences.
• Encouraging patient preference identification is key to effective shared decision-making and treatment satisfaction.