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Evidence-based care poorly understood by patients

Patients increasingly are being asked to make evidence-based health care decisions in managing chronic conditions, choosing treatments and selecting health care professionals. But a report released online June 3 in Health Affairs found deep-rooted misconceptions, lack of understanding of terms such as "medical evidence," "quality guidelines" and "quality standards," and a reluctance to ask questions of physicians. Researchers with the American Institutes for Research in Washington, D.C., surveyed more than 1,700 people through focus groups, in-depth interviews and an online survey conducted from August 2006 to December 2007. Among their findings: * 41% of respondents said they had not asked questions or told their doctors about problems because they were unsure how to talk to doctors or because physicians seemed rushed. * Only 34% recalled their physicians ever discussing what medical research had shown about the best way to manage their care. * A substantial portion expressed the view that "you get what you pay for." One in three agreed or strongly agreed with the statement that "medical treatments that work the best usually cost more than treatments that don't work as well." * More than half of respondents had never taken notes during a medical appointment or brought Internet information to discuss with their physicians. Twenty-eight percent had never brought questions to their doctors. Study author Kristin Carman, PhD, said physicians "are in a great position to help patients understand the value of using evidence." For instance, the survey found skepticism about quality guidelines and how they are set. She said physicians need to help patients understand that quality measures and guidelines come from evidence and that doctors are often the ones setting the standards. There's much at stake in getting these points across, she said. If patients are more involved in making decisions about their care and managing conditions, results can lead to better adherence to treatment, better outcomes and more affordable care. Physicians play a crucial role in making patients feel that their input is not only acceptable but encouraged, Carman said. For example, she said, a physician's staff could remind a patient before an appointment to bring questions. "How powerful would it be for the doctor to say, 'Did you bring your list of questions for me today?' Patients are very concerned about how physicians are going to react to these new roles and behaviors we're all suggesting they take on." The study is online (www.ncbi.nlm.nih.gov/pubmed/20522522/). The full and original article can be found here: http://www.ama-assn.org/amednews/2010/06/28/prsq0630.htm
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