Physician Awareness of Patients' Preferred Level of Involvement in Decision Making

Study Overview
=================
Brief Summary
-----------------
Understanding a patient's decision-making preferences can help physicians meet their expectations and may increase patient satisfaction with the decision-making process.

Detailed Description
-----------------
Many health systems are shifting policies to promote greater patient involvement in healthcare delivery. Studies have shown that general medical patients who are more active in their care are more satisfied, more committed, have a better understanding of treatment plans, and experience greater improvements in health and patient-centered outcomes when compared to more passive patients. That being said, studies have found that patients have varying preferences when it comes to decision making. Understanding a patient's decision-making preferences can help physicians meet their expectations and may increase patient satisfaction with the decision-making process. This awareness of decision-making preferences could be beneficial in treating quality of life conditions. Patients seeking care for pelvic floor disorders make medical decisions aimed toward improving symptoms, function, and quality of life. In a recent study, researchers found that 50% of women preferred active involvement, 45% collaborative and 5% passive. However, patients were 1.56 (95% CI:1.06-2.29) times more likely to report collaborative or passive involvement after their visit (p=0.02) with 40% of patients rating their actual role as active, 48% as collaborative, and 11% as passive. In this study, 37% of women did not experience their preferred level of decision-making. Other studies have similar findings with reported 20-40% discordance between patients' preferred involvement and what was achieved. Discordance can negatively impact patients' outcomes and experiences of care. Interventions to minimize discordance between patients' preferred and perceived involvement in decision-making may significantly improve their overall experience and satisfaction. One possible intervention is eliciting women's preferred level of involvement in decision making prior to the visit and making this information available to the physician. The current study aims to determine whether physicians' awareness of patients' preferred involvement in decision making prior to their initial urogynecologist visit affects patients' perceived involvement in decision making after their visit.

Official Title
-----------------
Physician Awareness of Patients' Preferred Level of Involvement in Decision Making

Conditions
-----------------
Preferred Level of Involvement in Decision Making

Intervention / Treatment
-----------------
* Other: Physician Awareness
* Other: Usual Care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Present to Loyola's Urogynecology clinic for their initial evaluation Agree to complete the study questionnaires Must be at least 18 years of age Must be able to read, speak and write in English Exclusion Criteria: Established patients at Loyola's Urogynecology clinic Unable to complete the study questionnaires Less than 18 years of age Unable to read, speak and write in English

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Women will be randomly assigned to physician awareness or treatment as usual (control) using a 1:1 allocation
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Physician Awareness<br>The physician will have access to the pre-visit Control Preference Scale survey results for women assigned to this group | Other: Physician Awareness<br>* The patients' pre-visit Control Preference Scale responses are shared with their physician.<br>|
| Active Comparator: Usual Care<br>The physician will not have access to the pre-visit Control Preference Scale survey results for women assigned to this group | Other: Usual Care<br>* The patients' pre-visit Control Preference Scale responses are not shared with their physician.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Discordance rate for the Control Preference Scale | The Control Preference Scale assesses patients' preferences for involvement in decision-making. The scale ranks patients' preferences for involvement in their healthcare as either active, collaborative, or passive. Patients' CPS responses will be compared between the intervention and usual care cohorts. | 1 day visit |