Decision-Making Role Preferences Among Patients with HIV

Associations with Patient and Provider Characteristics and Communication Behaviors

HIV Patients who screened positive for depression were less likely to want an active role in making decisions regarding treatment.

This article presents the results of a study that investigated how HIV patients and their providers communicate and make decisions regarding treatment and medication adherence. The study examined factors that might lead HIV patients to prefer a more active role in the decision-making process.

The Enhancing Communication and HIV Outcomes (ECHO) Study took place at provider locations in four U.S. cities. Research assistants collected demographic data from patients and providers. In addition, they screened patients for depression. Patients rated their providers’ communication and overall quality of care.

Recruitment occurred in the waiting room prior to a patient-provider visit. Providers and patients completed questionnaires about communication and decision-making. Following the visit, patients answered the question, “What role do you want to play in your medical care?” There were four possible responses, each indicating a preference for a degree of input in the decision-making process (e.g., the doctor considers some of my ideas but still makes most, if not all, of the final decisions).

Key Findings:

  • Patients who rated highly their providers’ communication preferred to take an active role in the decision-making process.
  • Patients who preferred a shared decision-making role were more likely to be African-American than White.

This article examines the decision-making role preferences of HIV patients who took part in the ECHO Study. The results suggest that providers should not assume that a patient who is not an active communicator wants the provider to make all decisions regarding treatment and medication.


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