Trust is a fundamental feature of the patient–physician relationship1–5 that correlates with patient satisfaction, continuity of care, adherence to medical therapy, and other desirable practice metrics.1,4,6–9 Despite the importance of trust, efforts to improve patient trust in their clinicians have been sparse and largely inconclusive.1,2
Certain patient and clinician characteristics may affect trust. Observational studies show that patients preferring passive or shared roles in decision making have higher levels of trust than their more autonomous counterparts.5,10,11 Clinician characteristics best correlated with patient trust include manifestations of caring and comfort, demonstration of competency, explaining actions, and encouraging and answering patient questions.4
The nature of the clinical visit could also affect trust. Decision aids are tools that, among other purposes, help clinicians share unbiased evidence-based information and uncertainty with patients to improve the quality of clinical decisions.12 The extent to which using decision aids in practice can favourably or unfavourably affect patient-perceived trust in the clinician who uses them remains unknown.
We have previously reported on the development and purpose of the decision aid Statin Choice13 which can be found on our website (http://kerunit.e-bm.org), and on the main results of the Statin Choice trial. This trial showed that a decision aid was acceptable to patients, positively influenced patient knowledge and decisional conflict about using statins, enhanced the risk-appropriate use of statins, and improved short-term adherence to statins.14 Here, we report on the extent to which use of this treatment decision aid in patients with type 2 diabetes improved their trust in a specialty provider, a pre-specified secondary endpoint. We also examined the association between trust and other variables to begin to elucidate determinants of trust.