Characteristics of shared decision making in Romania from the patient perspective: A cross‐sectional multicentric study

Abstract

Background Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. Material and methods A cross‐sectional multicentric study comprising eight recruitment centres was performed. Inpatients and outpatients who referred to Hospital Units treating autoimmune diseases or atrial fibrillation were included. Another sample consisted of members of the Autoimmune Disease Patient Society, who completed an online anonymous questionnaire. All participants completed the Romanian translated version of the 9‐item Shared Decision Making Questionnaire (SDM‐Q‐9), as these samples were used for the validation of this questionnaire, too. Patients had to refer to the visit in which the decision concerning the antithrombotic treatment was taken (atrial fibrillation patients), or the immunosuppressive treatment was last time changed (autoimmune disease patients). Ordinal regression having the total SDM score as dependent variable was used. Results A total of 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The median score for SDM was 34 of 45, but it differed between hospital completion –39/45 and online completion (anonymous) –20/45 (P < .001). Patients with higher education were influenced most by the setting, giving the best marks in hospital and low marks online, while those with lower education gave lower marks in both settings. In ordinal regression with SDM score as dependent variable, hospital completion of the questionnaire (OR = 9.5, 95% confidence interval, 5.69‐16), collagen disease diagnosis (OR = 2.4, 95% confidence interval, 1.39‐4.14), and immunosuppressive treatment (OR = 2.16, 95% confidence interval, 1.43‐3.26) were independent predictors. Conclusion In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical.

Patient Perspectives on Factors Affecting Direct Oral Anticoagulant Use for Stroke Prevention in Atrial Fibrillation

“…Consistent with prior survey research, 30 , 45 , 46 patients experiencing joint or autonomous decision-making were told about more than one therapy option. They had an opportunity to voice their preferences, which were shaped by their knowledge about OAs gained from their clinicians or social network, perceived safety of OAs, and how well it would fit with their lifestyle and work arrangements.…”

Shared decision making and patients satisfaction with strabismus care—a pilot study

“…In this previously approved questionnaire, the SDM level was assessed subjectively by evaluating the nine phases of the decision-making process from the patient's perspective on a 6-point Likert scale ranging from 0 (not at all) to 5 (fully applicable) [13] (see Additional file 1: Appendix SDM-Q-9 questionnaire). Romanian version had good internal consistency with a 0.96 Cronbach α coefficient [31].…”

“…Median (95% CI) 23(19)(20)(21)(22)(23)(24)(25)(26) 23 (23-28) 27 (24-34) 25(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) …”

Research update for articles published in EJCI in 2017

“…We wanted to verify the first two statements on patients, but we acknowledged that the patients with atrial fibrillation did not know why they took antithrombotic therapy. Therefore, first we made a study to validate the Romanian version of a questionnaire for the assessment of the shared decision‐making (SDM), we assessed the SDM process as perceived by the patients, using this questionnaire, and we assessed the Romanian patients’ awareness concerning the complications and treatment of atrial fibrillation (not yet published). Only 55% of them knew that they were in danger of ischaemic stroke, while 62% knew that the antithrombotic medication prevented stroke.…”