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

By Christiane Bieber, Knut Georg Mqller, Klaus Blumenstiel, Achim Hochlehnert, Stefanie Wilke, Mechthild Hartmann, Wolfgang Eich

Journal of Psychosomatic Research 64 (2008) 13 – 20

Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Tel.: +49 6221 56 38657; fax: +49 6221/56 5988. E-mail address: christiane.bieber@med.uni-heidelberg.de (C. Bieber).

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 ( Pb.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.

 

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