Factors associated with level of shared decision making in Malaysian primary care consultations
Document Type
Article
Publication Date
5-1-2020
Abstract
Objective: To measure the level of shared decision-making (SDM) in primary care consultations in Malaysia, a multicultural, middle-income developing country. Methods: A cross-sectional study was conducted in an urban, public primary care clinic. Convenience sampling was used to recruit participants, and audio-recorded consultations were scored for SDM levels by two independent raters using the OPTION tool. Univariate and multivariate analysis was conducted to determine factors significantly associated with SDM levels. Results: 199 patients and 31 doctors participated. Mean consultation time was 14.3 min (+/- SD 5.75). Patients' age ranged from 18 to 87 years (median age of 57.5 years). 52.8 % of patients were female, with three main ethnicities (Malay, Chinese, Indian). The mean OPTION score was found to be 7.8 (+/- SD 3.31) out of 48. After a multivariate analysis, only patient ethnicity (beta= -0.142, p < 0.05) and increased consultation time (beta = 0.407, p < 0.01) were associated with higher OPTION scores. Conclusions: Patients in Malaysia experience extremely poor levels of SDM in general practice. Higher scores were associated with increased consultation time and patient ethnicity. Practice implications: Malaysian general practitioners should aim to develop and practice cultural competency skills to avoid biased SDM practice towards certain ethnicities. (C) 2019 Elsevier B.V. All rights reserved.
Keywords
Shared decision making, Malaysia, Consultation, Primary care
Divisions
fac_med,primarycare
Publication Title
Patient Education and Counseling
Volume
103
Issue
5
Publisher Location
ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND