Anke Friedrichs1, Anna Silkens2, Jens Reimer3, Ludwig Kraus4, Norbert Scherbaum2, Daniela Piontek5, Jeanette Röhrig6, Jochen Hempleman7, Martin Härter8, Angela Buchholz8. 1. Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre, Hamburg, Germany. Electronic address: an.friedrichs@uke.de. 2. LVR-Hospital Essen, Department of Addictive Behavior and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany. 3. Centre for Interdisciplinary Addiction Research, University of Hamburg, Germany; Centre for Psychosocial Medicine, Health North, Bremen, Germany. 4. IFT Institute for Therapeutic Research Munich, Germany; Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden. 5. IFT Institute for Therapeutic Research Munich, Germany. 6. Hospital Stuttgart, Department for Clinical Psychology, Stuttgart, Germany. 7. LWL-Hospital Münster, Outpatient Department for Addiction, Münster, Germany. 8. Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre, Hamburg, Germany.
Abstract
AIMS: Shared decision making (SDM) is increasingly demanded in medical decision making. SDM acknowledges patients' role preferences in decision making processes. There has been limited research on SDM and role preferences in substance use disorders; results are promising. Aim of this study was to investigate role preferences of patients with alcohol use disorders (AUD), and to identify predictors of these preferences. METHOD: Cross-sectional data collected from June 2013 to May 2014 in four detoxification wards in Germany during a randomised controlled trial (RCT, Registration Code 01GY1114) was analysed. Of the 250 patients with AUD who were included in the RCT, data from 242 patients [65% male; mean age = 45.2 years (sd = 10.3)] were analysed. Participants' role preferences were assessed with the Control Preference Scale. Potential correlates were drawn from instruments used in the RCT; multinomial logistic regression was used. RESULTS: 90% (n = 217) of the AUD patients preferred an active or shared role in decision-making, 10% (n = 25) preferred a passive role. Patients' desire for help was associated with their role preference (OR = 3.087, p = .05). The model's goodness of fit was Nagelkerke's R2 = 0.153 [χ2 (24) = 25.206, p = .395]. CONCLUSIONS: Patients' preference for an active role in decision-making underscores the importance of involving patients in their treatment planning. Patients' desire for help seems to be an important determinant of paternalistic decision making. However, further research is needed to determine whether patients' role preferences are related to their behavior during their treatment referral and recovery.
AIMS: Shared decision making (SDM) is increasingly demanded in medical decision making. SDM acknowledges patients' role preferences in decision making processes. There has been limited research on SDM and role preferences in substance use disorders; results are promising. Aim of this study was to investigate role preferences of patients with alcohol use disorders (AUD), and to identify predictors of these preferences. METHOD: Cross-sectional data collected from June 2013 to May 2014 in four detoxification wards in Germany during a randomised controlled trial (RCT, Registration Code 01GY1114) was analysed. Of the 250 patients with AUD who were included in the RCT, data from 242 patients [65% male; mean age = 45.2 years (sd = 10.3)] were analysed. Participants' role preferences were assessed with the Control Preference Scale. Potential correlates were drawn from instruments used in the RCT; multinomial logistic regression was used. RESULTS: 90% (n = 217) of the AUD patients preferred an active or shared role in decision-making, 10% (n = 25) preferred a passive role. Patients' desire for help was associated with their role preference (OR = 3.087, p = .05). The model's goodness of fit was Nagelkerke's R2 = 0.153 [χ2 (24) = 25.206, p = .395]. CONCLUSIONS:Patients' preference for an active role in decision-making underscores the importance of involving patients in their treatment planning. Patients' desire for help seems to be an important determinant of paternalistic decision making. However, further research is needed to determine whether patients' role preferences are related to their behavior during their treatment referral and recovery.
Authors: Kirsten Marchand; Scott Beaumont; Jordan Westfall; Scott MacDonald; Scott Harrison; David C Marsh; Martin T Schechter; Eugenia Oviedo-Joekes Journal: Subst Abuse Treat Prev Policy Date: 2019-09-11
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