Medical students, doctors and nurses can be taught to use a more holistic, patient-centered approach during medical consultations, focusing on the person and not just their medical complaint, finds a new review in The Cochrane Library. Furthermore, short term training (less than 10 hours) was as effective as longer-term training.
Patient-centered care, which figures prominently in the new U.S. healthcare reform bill, is being promoted for its potential to encourage good health behavior and health outcomes, and to possibly reduce healthcare costs.
"Our study showed that healthcare providers can be trained effectively to involve patients in those patients' own health decisions. Providers, including those still in training, can acquire skills to enhance their communication with patients about their concerns and treatment options," wrote review authors Francesca Dwamena, M.D. and Robert Smith, M.D., of the College of Medicine at Michigan State University and Gelareh Sadigh, M.D., of the University of Michigan Medical Center.
The 43 studies reviewed involved teaching clinicians how to share control of the medical consultation process and health care decision-making by focusing on patients' personal preferences. Health care providers and patients who participated in the patient-centered interventions reported small improvements in patient satisfaction, the health care consultation process and health status.
John F. P. Bridges, Ph.D., associate professor in the Department of Health Policy & Management at the Johns Hopkins School of Public Health commented that though the review was accurate, implementation of the findings about the promotion of promote patient-centered care is limited by the lack of a detailed understanding of what actually constitutes patient-centeredness.
"There's a general lack of understanding of what patients truly desire from health care," Bridges notes. "Successfully designing and implementing interventions to promote patient-centeredness in the absence of such a comprehensive understanding of the needs and wants of patients is like trying to design modern drugs in the absence of an understanding of biology. How much of these things should we be doing, and what nature of things? Where? And what is it worth?"
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Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, Lewin S, Smith RC, Coffey J, Olomu A. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews. 2012, Issue 12. Art. No.: CD003267. DOI: 10.1002/14651858.CD003267.pub2