Table 3

Perceptual differences between prescribing clinicians and their patients in relation to patient participation in decision-making about medication changes (created by the authors)

Clinicians’ perspective on patient participation in decision-making
Trial implementation data on the SDM component of the OPERAM intervention for intervention patients (n=27)*
n (%) of intervention patients for whom medication changes were discussed23 (85)
n (%) of intervention patients for whom formal SDM was performed19 (70)
SDM-Q-DOC score (median (P25–P75))†
 Total participating prescribing clinicians (n=17)76 (69–82)
 Prescribing clinicians’ intervention group (n=10)77 (74–81)
 Prescribing clinicians’ control group (n=7)69 (53–81)
n (%) of patients reporting participation in decision-making‡
 All patients (n=48)11 (23)
 Intervention patients (n=27)8 (30)
 Control patients (n=21)3 (14)
  • *Implementation of SDM as perceived by the research clinician who performed the OPERAM intervention. Formal SDM was defined according to the standard operating procedure on SDM used in the OPERAM trial, based on the collaborative deliberation model.

  • †SDM-Q-DOC scores were available for 17/48 interviewed patients’ clinicians (from both intervention and control groups). The SDM-Q-DOC was completed by the research clinician (intervention group) or the patients’ prescribing clinician (control group) who proposed the medication changes to the patient. Scores on the SDM-Q-DOC range between 0 and 100 with 0 representing the lowest possible level of SDM and 100 the highest possible level.

  • ‡As reported by patients in the semi-structured interviews. Decision-making was classified as ‘patient participation in decision-making’ if the patient reported some extent of patient participation, varying from patients reporting having been asked for their approval on medication changes (patient consultation), decision shared or having decided autonomously after being informed. Decision-making was classified as ‘paternalistic decision-making’ if the patient reported that the decision was taken by the clinician and the patient was informed afterwards.

  • SDM, shared decision-making; SDM-Q-DOC, physician version of the 9-item SDM questionnaire.