What factors promote the chronic disease patients’ participation in shared decision making of medication: a cross-sectional survey in Hubei Province, China

Abstract

Background: Shared decision making (SDM) improves the health status of patients with chronic disease, especially in the condition of poly-medicated patients. This study aims to find the factors associated with chronic disease patients’ participation in SDM of medication. Methods: A total of 1,196 patients with chronic disease were selected using cluster sampling method. The random forest method was applied to sort the importance of independent variables by Mean Decrease Gini coefficient, and the multiple logistic regression was used to explore the key factors associated with patients’ medication decision-making. Results: In this study, 5.18% of patients used informed decision-making (IDM), 37.79% of patients used SDM, and 57.02% of patients used paternalistic model. The random forest showed that the top 10 important factors are exercise, age, education, drinking, disease course, medication knowledge, gender, depression, job type, and compliance. The multiple logistic regression showed that patients over 65 years old, drinking always, with depressive symptoms, poor knowledge and compliance of medication are more likely to use IDM compared to SDM. Moreover, compared to SDM, those patients over 65 years old, exercise infrequently, with disease course over 10 years, depressive symptoms, poor medication knowledge and an occupation of manual labor were more likely to use paternalistic model. Conclusion: Patients’ health behaviors and medication knowledge significantly influenced the patients’ participation in SDM of medication. Related interventions should be executed to ameliorate the health behaviors and medication knowledge of patients with chronic disease to promote them participating in SDM of medication