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

J Psychosom Res. 2008 Jan;64(1):13-20. 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<.001). We found no differences in secondary outcome measures.

Conclusions: SDM with FMS patients might be a possible means to achieve a positive quality of physician-patient interaction. A specific SDM communication training program teaches physicians to perform SDM and reduces frustration in patients.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication*
  • Decision Making*
  • Female
  • Fibromyalgia / psychology
  • Fibromyalgia / therapy*
  • Humans
  • Inservice Training*
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Patient Participation / psychology*
  • Patient Satisfaction
  • Physician-Patient Relations*
  • Psychophysiologic Disorders / psychology
  • Psychophysiologic Disorders / therapy*