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Race, Ethnicity, and Shared Decision Making for Hyperlipidemia and Hypertension Treatment: The DECISIONS Survey

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  • Neda Ratanawongsa
  • Brian J. Zikmund-Fisher
  • Mick P. Couper
  • John Van Hoewyk
  • Neil R. Powe

Abstract

Background Racial/ethnic differences in shared decision making about cardiovascular risk-reduction therapy could affect health disparities. Objective To investigate whether patient race/ethnicity is associated with experiences discussing cardiovascular risk-reduction therapy with health care providers. Setting National sample of US adults identified by random-digit dialing. Design Cross-sectional survey conducted in November 2006 to May 2007. Participants Among participants in the National Survey of Medical Decisions (DECISIONS), a nationally representative sample of English-speaking US adults aged 40 and older, the authors analyzed respondents who reported discussing hyperlipidemia or hypertension medications with a health care provider in the previous 2 years. Measurements In multivariate linear and logistic regressions adjusting for age, gender, income, insurance status, perceived health, and current therapy, they assessed the relation between race/ethnicity (black/Hispanic v. white) and decision making: knowledge, discussion of pros and cons of therapy, discussion of patient preference, who made the final decision, preferred involvement, and confidence in the decision. Results Of respondents who discussed high cholesterol (N = 738) or hypertension (N = 745) medications, 88% were white, 9% black, and 4% Hispanic. Minorities had lower knowledge scores than whites for hyperlipidemia (42% v. 52%, difference –10% [95% confidence interval (CI): 15, –5], P

Suggested Citation

  • Neda Ratanawongsa & Brian J. Zikmund-Fisher & Mick P. Couper & John Van Hoewyk & Neil R. Powe, 2010. "Race, Ethnicity, and Shared Decision Making for Hyperlipidemia and Hypertension Treatment: The DECISIONS Survey," Medical Decision Making, , vol. 30(5_suppl), pages 65-76, September.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:5_suppl:p:65-76
    DOI: 10.1177/0272989X10378699
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    References listed on IDEAS

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    1. Brian J. Zikmund-Fisher & Mick P. Couper & Eleanor Singer & Carrie A. Levin & Floyd J. Fowler Jr. & Sonja Ziniel & Peter A. Ubel & Angela Fagerlin, 2010. "The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions," Medical Decision Making, , vol. 30(5_suppl), pages 20-34, September.
    2. Johnson, R.L. & Roter, D. & Powe, N.R. & Cooper, L.A., 2004. "Patient race/ethnicity and quality of patient-physician communication during medical visits," American Journal of Public Health, American Public Health Association, vol. 94(12), pages 2084-2090.
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    1. Attanasio, Laura B. & Hardeman, Rachel R., 2019. "Declined care and discrimination during the childbirth hospitalization," Social Science & Medicine, Elsevier, vol. 232(C), pages 270-277.

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