Medical Decision Making
Patient responsibility for medical decision making and risky treatment options
Article first published online: 30 NOV 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 12, pages 1674–1676, 15 December 2009
How to Cite
Fraenkel, L. and Peters, E. (2009), Patient responsibility for medical decision making and risky treatment options. Arthritis & Rheumatism, 61: 1674–1676. doi: 10.1002/art.24947
- Issue published online: 30 NOV 2009
- Article first published online: 30 NOV 2009
- Manuscript Accepted: 14 AUG 2009
- Manuscript Received: 17 APR 2009
- NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases K23 award). Grant Number: AR-048826-01
Studies have shown that increasing patient participation in decision making decreases utilization of risky procedures. It has been demonstrated that risk perception is increased under conditions that emphasize volition, or the act of choosing. The objective of this study was to examine whether emphasizing volition increases patients' risk perception and decreases their willingness to accept risk.
Consecutive patients attending outpatient clinic appointments viewed a video in which a physician described the availability of a new medication associated with a rare risk of a serious side effect. Patients' willingness to accept treatment and worry about the risk of the serious side effect were measured under 2 different conditions: one that minimized patient involvement and the one that maximized patient involvement in the decision-making process.
The willingness of the subject to take the proposed medication was lower (mean ± SD 4.2 ± 3.7 versus 5.3 ± 3.7; P < 0.001) and their worry about the risk of the adverse event was greater in the high compared with the low involvement condition (mean ± SD 6.1 ± 3.7 versus 5.5 ± 3.8; P < 0.001).
Increasing patient responsibility in medical decision making may decrease the patient's willingness to accept risky treatment options.