Research project
Title: Shared decision-making and risk communication in general practice
Project timescale: From 01 October, 1999 to 01 April, 2002
(Added to website on: 18 October, 2004 - Date last updated: 11 February, 2013)
Source of funding:
Department of Health (DH) Health in Partnership Policy Research Programme
Aims: To evaluate the effects of the shared decision making and risk communication interventions on consultation processes and patient-based outcomes, both separately and in combination.
Research designs used:
Evaluation
Randomised controlled trial
Study of views/experiences
Systematic review
Other: Health Economic
Methods used to collect data:
Documentary analysis
Focus groups
Interviews
Validated instruments eg Outcome measures
Questionnaire survey
Observation
Other (please specify):
Research project description: A randomised trial design with crossover was employed for this study. Participating doctors were randomised to receive either risk communication training OR shared decision making, AND THEN received that alternative intervention at a later stage of the study. The study incorporated systematic literature reviews, psychometric evaluation of outcome measures, and quantitative, qualitative and health economic analyses of a cluster randomised trial of professional skill development, all informed by consumer and patient engagement. The work was produced by a wide collaboration led by researchers from the Department of General Practice, University of Wales College of Medicine, Cardiff, including a consumers' advisory group and a patients' association. The study participants were 20 general practitioners from Gwent, their practice staff, and almost 800 patients in these practices.
Stages at which the public were involved:
Undertaking the research
Analysing the research
Writing about the research eg
publications, newsletters
Prioritising topic areas
Disseminating research
Planning the research
Implementing action
Managing the research
Designing the research instruments
(eg questionnaires, patient information sheets)
Other:
Description of public involvement in research stages: Consumers and patients contributed to several stages of the research from inception and design, securing of funding, implementation of the protocol, and interpretation and dissemination of the findings. A wide variety of 'user' participants were involved: patients participating in focus groups; patients' association members; individual consumers (or groups) working to enhance health-care quality or consumers or citizens. A broad range of experience and expertise in research matters was brought to the work by members of the public in these various capacities.
Training and support provided for either members of the public or researchers involved in the project:
Examples of ways the public have made a difference to the research project: Integral throughout. Individuals or groups were actively involved in varying degrees as active and contributing members of the enterprise. They contributed to study design; determination of outcomes; management of the trial; authorship of papers; determination of methods of dissemination and implementation. They were involved throughout as valuable contributors, or as members of the team, able to bring their own expertise and insight.
Evaluating the impact of public involvement in the research:
Details of publications or reports resulting from the research: (1) Edwards A, Elwyn G. Atwell C et al. Shared decision-making and risk communication in general practice - a study incorporating systematic literature reviews, psychometric evaluation of outcome measures, and quantitative, qualitative and health economic analyses of a cluster randomised trial of professional skill development. Report to 'Health in Partnership' programme, UK Department of Health. http://www.healthinpartnership.org/studies/edwards.html. Cardiff: Department of General Practice, University of Wales College of Medicine, 2002. (2) The Report lists the first 15 papers that were published in various medical journals. More have been published since that time and others are 'in press' (2004): E.g. Consumer (Thornton H) as Steering Group Member in: (i) Edwards A, Elwyn G, Atwell C, Hood K, Houston H, Kinnersley P, et al. Patient-based outcome results from a cluster randomised trial of shared decision making skill development and use of risk communication aids in general practice. Family Practice 2004, in press. (ii) Elwyn G, Edwards A, Hood K, Robling M, Atwell C, Russell I, Wensing M, Grol R et al. Achieving involvement: process outcomes from a cluster randomised controlled trial of shared decision making skill development and use of risk communication aids in general practice. Family Practice 2004, in press (3) The consumer view of the research was given in the following paper: Hazel Thornton, Adrian Edwards and Glyn Elwyn. Evolving the multiple roles of `patients` in health-care research: reflections after involvement in a trial of shared-decision-making. Health Expectations 2003; 6: 189-197. (4) Consumers co-authored the following paper: Edwards A, Elwyn G, Atwell C, Williams S, Thornton H. Consumers` views of quality in the consultation and their relevance to 'shared decision making' approaches. Health Expectations 2001; 4: 151-162.
Links to Reports:
Was/is your project user controlled: Not Known
For further information on the project, please contact:
Mrs Hazel Thornton
Involved consumer researcher, pre trial to post trial
Consumers' Advisory Group for Clinical Trials (CAG-CT)
31 Regent Street
Rowhedge
Colchester
CO5 7EA
hazelcagct@keme.co.uk
01206 728178
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