TRENDS: A National Survey of Medical Decisions
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2013 Winter Medical Editor's Meeting: Carrie Levin, PhD; Vickie Stringfellow, Bethany Gerstein
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TRENDS: A National Survey of Medical Decisions
- 1. A N a t i o n a l S u r v e y o f M e d i c a l D e c i s i o n s Trends Carrie Levin, Vickie Stringfellow, Bethany Gerstein Research January 2013
- 2. Why did we do the study? 2
- 3. Trends Study: Background • Conducted by IMDF/ Knowledge Networks • Address-based national Internet panel • 3,326 English speakingAmericans aged 40+ • Eligible if discussed at least 1 of 10 medical decisions with HCP in past 2 years • Response rate of 58% • Can’t compare to DECISIONS • Oversample of 500 inWashington State 3
- 4. Trends Study: Decisions Addressed 4 • Knee • Hip • Low Back • Cataracts Surgery • Colorectal • Breast (women) • Prostate (men) Cancer Screening • Depression • Blood pressure • Cholesterol Medication
- 5. Trends Study: Survey Questions 5 Knowledge: 3-5 questions for each topic that are the key things that patients need to know before making a decision Goals and Concerns: When thinking about whether to have intervention, how important was… Information Sources: How important was information from HCPs, media, friends or family, Internet Decision Process: Options, pros, cons, did provider give recommendation, did provider ask what patient wants to do Questions in Each Module
- 6. Epidemiology of Medical Decisions 6 In the Past 2 Years: 77% made at least 1 decision: 52% discussed starting or stopping medication 59% discussed a screening test 18% discussed surgery
- 7. Knowledge Question: % Correct 33% 35% 20% 42% 34% 84% 46% 43% 54% 48% 0% 20% 40% 60% 80% 100% KneeOA Hip OA Low Back Cataract Depression Hypertension Cholesterol Prostate Colorectal Breast 7 Cancer Screening Meds Surgery
- 8. Discussion of Pros & Cons 47% 33% 68% 34% 47% 28% 35% 8% 12% 6% 76% 80% 84% 83% 82% 77% 70% 41% 57% 45% 0% 20% 40% 60% 80% 100% KneeOA Hip OA Low Back Cataract Depression Hypertension Cholesterol Prostate Colorectal Breast 8 Cancer creening Meds Surgery Pros Cons
- 9. Decision Process Score 2.8 2.5 3.2 2.2 2.7 2.1 2.2 1.7 2.0 1.5 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 KneeOA Hip OA Low Back Cataract Depression Hypertension Cholesterol Prostate Colorectal Breast 9 Cancer Screening Meds Surgery
- 10. What do Patients Do? Have Surgery: 42% Take Medication: 79% Have Screening Test: 89% 10
- 11. 11 Thank You!
Notes de l'éditeur
- Goal: to determine how decisions are made in the USGather baseline dataHow these decisions are madeWho suggested whatThe details of the interactionWhat the patients knewWhere their information came fromWhat they cared aboutHow these patterns differBy patient characteristicsBy where patients liveBy what kind of decision is being made
- Why 40+?Because the rates of medical decisions are notably higher among those groups
- Avg score on knowledge items correct
- Proportion of respondents (and 95% confidence intervals) who reported discussing the pros and cons “Some” or “A lot” with their health care provider(s) for each topic
- 4 point scale: pros. Cons, options explained, patient asked opinion
- 42-89% of time doc recommends for a patient to have an intervention
- Medical decisions are a pervasive part of adult life in America.