A shared decision-making communication training program for physicians treating fibromyalgia patients: Effects of a randomized controlled trial

• Published in: Journal of psychosomatic research 2008, Vol.64 (1), p.13-20
• Main Authors: Bieber, Christiane, Müller, Knut Georg, Blumenstiel, Klaus, Hochlehnert, Achim, Wilke, Stefanie, Hartmann, Mechthild, Eich, Wolfgang
• Format: Article
• Language: English
• Subjects: Adult; Assessment; Biological and medical sciences; Chronic pain; Communication; Communication training; Decision Making; Doctor-Patient communication; Female; Fibromyalgia; Fibromyalgia - psychology; Fibromyalgia - therapy; Fibromyalgia syndrome; Health staff related problems. Vocational training; Humans; Inservice Training; Male; Medical sciences; Middle Aged; Patient Education as Topic; Patient Participation - psychology; Patient Satisfaction; Physician-Patient Relations; Physician–patient interaction; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychophysiologic Disorders - psychology; Psychophysiologic Disorders - therapy; Randomized controlled trial; Shared decision making; Social psychiatry. Ethnopsychiatry; Therapeutical relation and framework; Treatments
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2007.05.009

Abstract Objective Fibromyalgia syndrome (FMS) is a condition of chronic widespread pain that is difficult to control and is associated with strains in physician–patient interaction. Shared decision making (SDM) can be a potential solution to improve interaction. We evaluated the effects of an SDM intervention, including an SDM communication training program for physicians, in a randomized controlled trial with FMS patients. The main objective was to assess whether SDM improves the quality of physician–patient interaction from patients' perspective. Methods Patients were randomized to either an SDM group or an information-only group. The SDM group was treated by physicians trained in SDM communication and had access to a computer-based information package; the information-only group received only the information package and was treated by standard physicians. All patients were offered the same evidence-based treatment options for FMS. Patients were assessed with questionnaires on physician–patient interaction (main outcome criteria) and decisional processes. Physicians filled out a questionnaire on interaction difficulties. Assessment took place immediately after the initial consultation. Results Data from 85 FMS patients (44 in the SDM group and 41 in the information-only group) were analyzed. The mean age was 49.9 years (S.D.=10.2), and 91.8% of patients were female. The quality of physician–patient interaction was significantly higher in the SDM group than in the information-only group ( P