| The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. | |
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MedLine Citation:
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PMID: 20393104 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Patient involvement is required before patients' preferences can be reflected in the medical care they receive. Furthermore, patients are a vital link between physicians' assessments of patients' needs and actual implementation of appropriate care. Yet no study has specifically examined how and when a representative sample of patients considered, discussed, and made medical decisions. OBJECTIVE: To identify decision prevalence and decision-making processes regarding 1) initiation of prescription medications for hypertension, hypercholesterolemia, or depression; 2) screening tests for colorectal, breast, or prostate cancer; and 3) surgeries for knee or hip replacement, cataracts, or lower back pain. DESIGN: Computer-assisted telephone interview survey. SETTING: Nationally representative sample of US adults in households with telephones. PARTICIPANTS: 3010 English-speaking adults age 40 and older identified using a stratified random sample of telephone numbers. MEASUREMENTS: Estimated prevalence of medical decisions, defined as the patient having initiated medications, been screened, or had surgery within the past 2 years or having discussed these actions with a health care provider during the same interval, as well as decision-specific data regarding patient knowledge, attitudes and patient-provider interactions. RESULTS: 82.2% of the target population reported making at least 1 medical decision in the preceding 2 years. The proportion of decisions resulting in patient action varied dramatically both across decision type (medications [61%] v. screening [83%] v. surgery [44%]; P < 0.001), and within each category (e.g., blood pressure medications [76%] v. cholesterol medications [55%] vs. depression medications [48%]; P < 0.001). Respondents reported making more decisions if they had a primary care provider or poorer health status and fewer decisions if they had lower education, were male, or were under age 50. Limitations. Retrospective self-reports may incorporate recall biases. CONCLUSIONS: Medical decisions with significant life-saving, quality of life, and cost implications are a pervasive part of life for most US adults. The DECISIONS dataset provides a rich research environment for exploring factors influencing when and how patients make common medical decisions. |
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Authors:
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Brian J Zikmund-Fisher; Mick P Couper; Eleanor Singer; Carrie A Levin; Floyd J Fowler; Sonja Ziniel; Peter A Ubel; Angela Fagerlin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2010-04-14 |
Journal Detail:
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Title: Medical decision making : an international journal of the Society for Medical Decision Making Volume: 30 ISSN: 1552-681X ISO Abbreviation: Med Decis Making Publication Date: 2010 Sep-Oct |
Date Detail:
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Created Date: 2010-09-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8109073 Medline TA: Med Decis Making Country: United States |
Other Details:
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Languages: eng Pagination: 20S-34S Citation Subset: IM |
Affiliation:
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VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. bzikmund@umich.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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