Patient-Provider Communication Effectiveness

The Disparities Research Unit at Massachusetts General Hospital’s effectiveness trial aims to increase shared decision making among patients and their providers and to improve patient-centered quality of care and providers’ receptivity to patient activation.

The Disparities Research Unit at Massachusetts General Hospital has been selected for funding by the Patient Centered Outcomes Research Institute (PCORI), to address the importance of patient-provider communication, shared decision making, and therapeutic alliance. Experts suggest that deficiencies in quality behavioral health care could be addressed if providers sought patients’ perspective about their illness and shared power and responsibility. Shared decision making, a form of patient-provider communication where both parties bring expertise to make treatment decisions, has the potential to improve quality of behavioral health care. Our research team conducted a patient intervention (DECIDE-PA) that showed improvements in patient activation and self-management in behavioral health care. The current grant proposes to combine DECIDE-PA with a provider coaching intervention (DECIDE-PC) to increase providers’ receptivity to patient activation, and improve shared decision-making.

Objectives:

1) Test the effectiveness of DECIDE-PA and DECIDE-PC compared to usual care in improving shared decision-making and patient-perceived quality of behavioral health care

2) Test whether patient entered communication and therapeutic alliance mediate the effect of DECIDE-PA and DECIDE-PC on shared decision-making

3) Explore whether ethnic/racial or language matching between patient and provider moderates the relationship between the effect of DECIDE-PA and DECIDE-PC on shared decision making and quality of behavioral health care.

Funding Acknowledgement

This study is supported by Contract number CD-12-11-4187, funded by the Patient Centered Outcomes Research Institute (PCORI).