Patient preferred role in medical decision-making in Mexico City with different chronic diseases

Patient preferences about their role in decision-making in medical practice are a very important phenomenon, especially since patient participation allows decision-making to be more responsive to their needs and improves the quality of care.

To evaluate the proportion of patients with preferences toward an active, passive, or shared role in medical consultation in a sample of patients with chronic diseases who attend family medicine and general hospital level of care and to explore the relationship of preferences with sociodemographic and clinical variables.

Participants were recruited from their scheduled consultation in August, 2019, at one family medicine and one general hospital of the Mexican Institute of Social Security. People >18 years of age with different chronic disease diagnoses were surveyed. The Control Preferences Scale was applied to identify the participants' preferred role in decision-making related to medical care. The evaluation of health status and health-related quality of life was included. Multivariate analyses determined the predictors of participation preferences in decision-making.

A total of 530 patients participated. Most preferred the passive role (47.7%), followed by the shared role (27.7%) and the active role (24.5%). Age influenced preferences; participants ≥45 years preferred a shared role. Patients who reported poorer quality of life preferred the shared role in decision-making.

The study showed that patients with chronic diseases prefer to leave the decisions to doctors. Only patients <45 years with a good quality of life had a greater preference for participation in decision-making.