Effect of shared decision-making on trust in physicians in the management of systemic lupus erythematosus: The TRUMP2-SLE prospective cohort study

Abstract

ABSTRACTObjectivesFew studies have explored whether the involvement of patients in shared decision-making (SDM) is beneficial to the management of systemic lupus erythematosus (SLE). Therefore, this study investigated the relationship between patient participation in SDM and their trust in physicians using data from the TRUMP2-SLE study.MethodsData regarding the nine-item Shared Decision-Making Questionnaire (SDM-Q-9 scores), Trust in Physician Scale (TIPS) scores, and Abbreviated Wake Forest Physician Trust Scale (A-WFPTS) scores for interpersonal trust in a physician and trust in the medical profession were collected from patients with SLE who visited the outpatient clinics of five facilities in Japan through a self-administered questionnaire. The relationships between these scores were analyzed.ResultsThis study included 433 patients with SLE. The median baseline TIPS and A-WFPTS (attending physician version) scores were 82 (73–93) and 80 (70–95), respectively. A higher baseline SDM-Q-9 score was correlated with an increase in the TIPS score at 1 year (adjusted mean difference per 10-pt increase, 0.95 pt [95%CI 0.18–1.71]). A higher baseline SDM-Q-9 score was also correlated with a higher A-WFPTS score for interpersonal trust (adjusted mean difference per 10-pt increase, 2.16 pt [1.41-2.92]). The baseline A-WFPTS (general physician version) score of 65 (50–80) was also correlated with an increase in the A-WFPTS score at 1 year (adjusted mean difference per 10-pt increase, 1.28 pt [0.43–2.14]).ConclusionsEngagement of patients with SLE in SDM elevates their trust in the attending physicians and healthcare providers, potentially enhancing doctor-patient relationships and overall healthcare trust.KEY MESSAGESWhat is already known about this subject?➢The importance of the involvement of patients in shared decision-making (SDM) in the management of systemic lupus erythematosus (SLE) has been emphasized as one of the principles in the EULAR recommendation.What does this study add?➢The baseline SDM-Q-9 scores were correlated with the Trust in Physician Scale (TIPS) and the attending physician version of the Abbreviated Wake Forest Physician Trust Scale (A-WFPTS) scores at 1 year.➢The baseline SDM-Q-9 scores at baseline were correlated with the general physician version of the A-WFPTS score at 1 year.➢These results indicate that the involvement of patients with SLE in SDM increases their trust in the attending physicians and physicians in general.How might this impact on clinical practice or future developments?➢This study demonstrated the importance of SDM in maintaining long-term physician-patient relationship during the management of SLE.➢Involvement of patients with SLE in SDM may improve the doctor-patient relationship and trust in healthcare.