A survey of 1,027 HIV-infected patients was used in this research to examine how patient preference in decision-making affected outcome. The study population was mostly young African-American males. Respondents were asked to select one of these categories to describe their attitude toward treatment: "the doctor takes the initiative and decides what is best for me;" "the doctor considers some of my ideas but still makes [most] of the final decisions;" "the doctor and I make the final decisions together;" and "I make all of the final decisions." The authors then measured association between individual responses and three outcome measures: receipt of HAART (highly active antiretroviral therapy) among eligible patients; adherence to HAART, and absence of detectable HIV-1 RNA.
This research suggests that clinicians should encourage patients to share decisions, including patients that are highly independent decision-makers, because patients who shared decision-making had better outcomes than either patients who deferred completely to doctors or patients who made all decisions themselves. Future work is needed to understand effective ways of modifying patients' preferences for decision-making and to understand whether such modifications can improve patient outcomes.