Ensuring that patients understand, accept and follow recommended treatment plans is the first step towards the best possible outcome—medically for the patient and financially for the healthcare delivery system. Similarly, physicians are in the best position to individualize this treatment plan to one that is optimal for the patient.
Yet all too often patients resist their physician’s recommendation immediately or at the pharmacy, or they initially accept only to abandon treatment later. Why does this happen and what can be done about it?
We wanted to know more about how the level and quality of point-of-care engagement impacts a patient’s treatment plan. Can optimizing the doctor-patient conversation drive the common goal of optimized care? As part of a self-funded omnibus study, Market Strategies International looked at the extent to which patients feel engaged in the decision-making process, and whether high engagement patients behave differently and in ways that are more beneficial to their well-being, than low engagement patients.
Study Results on Point-of-Care Engagement
Recalling the axiom “a little knowledge is a dangerous thing,” we might expect that an ‘educated’ healthcare consumer would be more inclined to second-guess their physician’s initial recommendation, and discussing alternatives to the recommended treatment could exacerbate this trend. Should physicians simply “tell” a patient what medication to take? The pressure on physicians to see more patients per day and spend less time with each one would seemingly provide such an unintended benefit, but does that play out or is it a penny-wise, dollar-foolish approach?
We asked more than 550 patients, all with some type of chronic condition, about the extent to which their physician engaged them in the decision-making process. To identify patients who are engaged by their physician at the point-of-care, we used the Participatory Decision Making (PDM) scale, a validated battery of characteristics developed by Kaplan, et al.
We used a 5-point scale and a 3-question battery to assess the patients’ level of decision-making involvement:
- If there were a choice between treatments, would this doctor ask you to help make the decision?
- How often does this doctor make an effort to give you some control over your treatment?
- How often does this doctor ask you to take some of the responsibility for your treatment?
We then looked at any differences between high engagement and low engagement patients. Three key differences arose:
Engaged patients are more likely to accept their physician’s recommendation regarding treatment of their chronic condition. These patients reported being more informed about the effectiveness of prescribed medications, including potential side effects. Interestingly, engaged patients were also more likely to be satisfied with the cost of their treatment, which, in this case, was a prescription medication. Satisfaction with cost can also lead patients to stick with the recommended course of treatment.
Engaged patients are informed of different medical options yet are still more likely to follow their doctor’s recommendation than low engagement patients. More choices do not seem to lead patients to go against their doctor’s recommendation, as we hypothesized. In fact, low engagement patients reported being less informed about medical options and were actually more likely to leave their doctor’s office with an alternate prescription instead of the recommended treatment.
Engaged patients are more satisfied with their treatment overall. When patients feel informed and aware of options, they are more satisfied. This matters because we can infer that increased satisfaction motivates them to follow and stick with their treatment plan.
From hospitals to insurers to pharmaceuticals, point-of-care engagement has wide-ranging implications. Understanding what healthy engagement looks like and helping doctors optimize their treatment conversations can benefit a range of Health Services fields, not to mention the most important agent in the conversation, the patient.
Want to know more about our research into point-of-care engagement and how you can beneficially impact it? Let’s have a conversation. Contact me.