Patients generally opt for less-risky treatments

But not all patients are comfortable giving input on health care decisions, a new study finds.

By Christine S. Moyer — Posted Dec. 17, 2009

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Patients are less willing to try potentially risky treatments when physicians give them responsibility in making medical decisions, says a study in the Dec. 15 Arthritis Care & Research (link).

However, author Liana Fraenkel, MD, MPH, said doctors should continue encouraging patients to be active participants, but be aware that some people need additional support in selecting a treatment course.

The study analyzed responses of 216 adults after they watched one of two videos in which a physician described the availability of a new medication. Participants were patients at Yale University outpatient clinics from March to June 2008.

The medications, which were made up for the study, each had a potential side effect that was serious but rare.

The medication featured in one video prevented heart disease but could cause jaw necrosis. The drug in the other video treated chronic pain but could cause progressive multifocal leukoencephalopathy.

After viewing the videos, each participant received two sets of instructions. One stated that the physician prescribed the proposed medicine without input from the patient. The other said the physician left the decision to the patient.

Participants then rated on a scale of 0 to 10 their willingness to take the medication, their worry about developing the rare complication and the responsibility they would feel if complications occurred.

The study found that patients were more worried about complication risks and less willing to take the medication when they were encouraged to choose their own treatments. They were less worried when the physician prescribed the medication without patient input.

"Physicians should be sensitive to the fact that [sharing the decision-making responsibility] might make some patients perceive the risks more and so they should take more time discussing" treatment options and consequences, said Dr. Fraenkel, an associate professor at Yale University School of Medicine in Connecticut.

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