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Academia and the Profession |

Expanding Patient Involvement in Care: Effects on Patient Outcomes

SHELDON GREENFIELD, M. D.; SHERRIE KAPLAN, Ph.D., M.P.H.; and JOHN E. WARE Jr., Ph.D.
[+] Article and Author Information

Requests for reprints should be addressed to Sheldon Greenfield, M.D.; UCLA School of Medicine, 42-170 CHS, Center for the Health Sciences; Los Angeles, CA 90024.


Los Angeles and Santa Monica, California


©1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(4):520-528. doi:10.7326/0003-4819-102-4-520
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An intervention was developed to increase patient involvement in care. Using a treatment algorithm as a guide, patients were helped to read their medical record and coached to ask questions and negotiate medical decisions with their physicians during a 20-minute session before their regularly scheduled visit. In a randomized controlled trial we compared this intervention with a standard educational session of equal length in a clinic for patients with ulcer disease. Six to eight weeks after the trial, patients in the experimental group reported fewer limitations in physical and role-related activities (p < 0.05), preferred a more active role in medical decision-making, and were as satisfied with their care as the control group. Analysis of audiotapes of physician-patient interactions showed that patients in the experimental group were twice as effective as control patients in obtaining information from physicians (p < 0.05). Results of the intervention included increased involvement in the interaction with the physician, fewer limitations imposed by the disease on patients' functional ability, and increased preference for active involvement in medical decision-making.

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