Hines AL, et al. – This study was performed to investigate the prevalence and extent of informed decision–making (IDM) and patient–centered decision–making (PCDM) in primary care visits of African Americans with depression. The findings from the present study suggested that the relationships between IDM and PCDM with interpersonal ratings were moderated by overall patient–centeredness of the visit, which could be indicative of broader cross–cultural communication issues.

Methods

• In this study, the researchers performed a cross-sectional analysis of audiotaped clinical encounters and post-visit surveys of seventy-six patients and their clinicians.
• RIAS was used to characterize patient-centeredness of visit dialogue.
• IDM involved discussion of three components: the nature of the decision, alternatives, and pros/cons.
• PCDM involved discussion of: lifestyle/coping strategies, knowledge/beliefs, or treatment concerns.
• The relationship of IDM and PCDM with visit duration, overall patient-centeredness, and patient/clinician interpersonal ratings were inspected.

Results

• According to the findings obtained, approximately one- fourth of medication and counseling decisions included essential IDM elements and 40% included at least one PCDM element.
• IDM was related to patients feeling respected in counseling and liking clinicians in medication decisions in high patient-centered visits.
• Results revealed that IDM was not associated with clinician ratings.
• PCDM in counseling decisions was positively related to patients feeling respected and clinicians respecting patients in low patient-centered visits.