PATIENT participation in shared decision-making is said to be beneficial when it comes to disease management, yet, few studies have researched this in the management of systemic lupus erythematosus (SLE). In the TRUMP2-SLE study, conducted by Ryusuke Yoshimi et al., Yokohama City University Graduate School of Medicine, Japan, researchers sought to understand the association between patient participation in shared decision-making and their trust in their attending rheumatologist.
Levels of trust were measured over 1 year using data from 433 patients with SLE across five outpatient clinics using the Trust in Physician Scale (TIPS) and the Abbreviated Wake Forest Physician Trust Scale (A-WFPTS). Patients’ involvement in decision-making was captured using the SDM-Q-9 scale.
According to the researchers, patients who reported higher levels of engagement in shared decision-making at baseline demonstrated a significant increase in trust scores after 1 year. A 10-point rise in SDM-Q-9 scores was associated with a 0.95-point increase in TIPS scores and a 2.16-point increase in interpersonal trust in physicians, as measured by the A-WFPTS. Relationships between questionnaire scores were analyzed using general linear models, with cluster-robust estimation to provide data on clustering of outcomes given by multiple patient ratings with similar trust levels for one rheumatologist.
As well as experiencing greater trust in their doctor, the study demonstrated that patients felt increased trust in the broader medical profession. These findings highlight that physician–patient relationships can be strengthened by involving patients in their care decisions more, ultimately leading to better long-term outcomes. By involving patients with SLE in shared decision-making to a greater extent, rheumatologists may experience more trusting, stronger relationships with their patients and help to improve patient’s trust in healthcare overall.
Reference: Yoshimi R et al. Effect of shared decision-making on trust in physicians in the management of systemic lupus erythematosus: The TRUMP2-SLE prospective cohort study. Arthritis Care Res (Hoboken). 2024. [Epub ahead of print].
Anaya Malik | AMJ
