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Shared Decision Making Does Not Influence Physicians against Clinical Practice Guidelines

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  • Mireille Guerrier
  • France Légaré
  • Stéphane Turcotte
  • Michel Labrecque
  • Louis-Paul Rivest

Abstract

Background: While shared decision making (SDM) and adherence to clinical practice guidelines (CPGs) are important, some believe they are incompatible. This study explored the mutual influence between physicians’ intention to engage in SDM and their intention to follow CPGs. Methods: Embedded within a clustered randomized trial to assess the impact of training physicians in SDM about using antibiotics to treat acute respiratory tract infections, this study evaluated physicians’ intentions to both engage in SDM and follow CPGs. A self-administered questionnaire based on the theory of planned behavior evaluated both behavioral intentions and their respective determinants (attitude, subjective norm and perceived behavioral control) at study entry and exit. We used path analysis to explore the relationships between the intentions. We conducted statistical analyses using the maximum likelihood method and the variance-covariance matrix. Goodness of fit indices encompassed the chi-square statistic, the comparative fit index and the root mean square error of approximation. Results: We analyzed 244 responses at entry and 236 at exit. In the control group, at entry we observed that physicians’ intention to engage in SDM (r = 0, t = 0.03) did not affect their intention to follow CPGs; however, their intention to follow CPGs (r = −0.31 t = −2.82) did negatively influence their intention to engage in SDM. At exit, neither behavioral intention influenced the other. In the experimental group, at entry neither behavioral intention influenced the other; at exit, the intention to engage in SDM still did not influence the intention to use CPGs, although the intention to follow CPGs (r = −0.15 t = −2.02) slightly negatively influenced the intention to engage in SDM, but this was not clinically significant. Conclusion: Physicians’ intention to engage in SDM does not affect their intention to adopt CPGs even after SDM training. Physicians’ intention to adopt CPGs had no clinically significant influence on intention to engage in SDM. Trial Registration: ClinicalTrials.gov NCT01116076

Suggested Citation

  • Mireille Guerrier & France Légaré & Stéphane Turcotte & Michel Labrecque & Louis-Paul Rivest, 2013. "Shared Decision Making Does Not Influence Physicians against Clinical Practice Guidelines," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-7, April.
    • Handle: RePEc:plo:pone00:0062537
    DOI: 10.1371/journal.pone.0062537
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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
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    1. Ali Ben Charif & Jordie Croteau & Rhéda Adekpedjou & Hervé Tchala Vignon Zomahoun & Evehouenou Lionel Adisso & France Légaré, 2019. "Implementation Research on Shared Decision Making in Primary Care: Inventory of Intracluster Correlation Coefficients," Medical Decision Making, , vol. 39(6), pages 661-672, August.

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