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• W2890883872 abstract "Background We report follow-on research from our previous qualitative analysis of how neurologists offer patients choice in practice. This focus reflects the NHS’s emphasis on ‘patient choice’ and the lack of evidence-based guidance on how to enact it. Our primary study identified practices for offering choice, which we called ‘patient view elicitors’ (PVEs) and ‘option-listing’. However, that study was not designed to compare these with recommendations or to analyse the consequences of selecting one practice over another. Objectives To (1) map out (a) the three decision-making practices – recommending, PVEs and option-listing – together with (b) their interactional consequences; (2) identify, qualitatively and quantitatively, interactional patterns across our data set; (3) statistically examine the relationship between interactional practices and self-report data; and (4) use the findings from 1–3 to compare the three practices as methods for initiating decision-making. Design A mixed-methods secondary analysis of recorded neurology consultations and associated questionnaire responses. We coded every recommendation, PVE and option-list together with a range of variables internal (e.g. patients’ responses) and external to the consultation (e.g. self-reported patient satisfaction). The resulting matrix captured the qualitative and quantitative data for every decision. Setting and participants The primary study was conducted in two neurology outpatient centres. A total of 14 neurologists, 223 patients and 114 accompanying others participated. Results Distribution of practices – recommending was the most common approach to decision-making. Patient demographics did not appear to play a key role in patterning decisional practices. Several clinical factors did show associations with practice, including (1) that neurologists were more likely to use option-lists or PVEs when making treatment rather than investigation decisions, (2) they were more certain about a diagnosis and (3) symptoms were medically explained. Consequences of practices – option-lists and PVEs (compared with recommendations) – were strongly associated with choice by neurologists and patients. However, there was no significant difference in overall patient satisfaction relating to practices employed. Recommendations were strongly associated with a course of action being agreed. Decisions containing PVEs were more likely to end in rejection. Option-lists often ended in the decision being deferred. There was no relationship between length of consultation and the practice employed. Limitations A main limitation is that we judged only outcomes based on the recorded consultations and the self-report data collected immediately thereafter. We do not know what happened beyond the consultation. Conclusions Patient choice is harder to enact than policy directives acknowledge. Although there is good evidence that neurologists are seeking to enact patient choice, they are still more likely to make recommendations. This appears to be partly due to concerns that ‘choice’ might conflict with doctors’ duty of care. Future guidance needs to draw on evidence regarding choice in practice to support doctors and patients to achieve the wider goal of shared decision-making. Future research To advance understanding of how interactional practices might have effects beyond the clinic, a priority is to investigate associations between decision-making practices and external outcomes (such as adherence). Funding The National Institute for Health Research Health Services and Delivery Research programme." @default.
• W2890883872 created "2018-09-27" @default.
• W2890883872 creator A5025085243 @default.
• W2890883872 creator A5039251718 @default.
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• W2890883872 creator A5091649612 @default.
• W2890883872 date "2018-09-01" @default.
• W2890883872 modified "2023-10-17" @default.
• W2890883872 title "Evaluating nuanced practices for initiating decision-making in neurology clinics: a mixed-methods study" @default.
• W2890883872 cites W1527200091 @default.
• W2890883872 cites W1542007054 @default.
• W2890883872 cites W1548505556 @default.
• W2890883872 cites W1814500150 @default.
• W2890883872 cites W1943745580 @default.
• W2890883872 cites W1961599511 @default.
• W2890883872 cites W1965027582 @default.
• W2890883872 cites W1967199440 @default.
• W2890883872 cites W1968470855 @default.
• W2890883872 cites W1971496392 @default.
• W2890883872 cites W1971770137 @default.
• W2890883872 cites W1972776276 @default.
• W2890883872 cites W1974294929 @default.
• W2890883872 cites W1976770755 @default.
• W2890883872 cites W1989662249 @default.
• W2890883872 cites W1992942093 @default.
• W2890883872 cites W1993807875 @default.
• W2890883872 cites W1993964237 @default.
• W2890883872 cites W2013366092 @default.
• W2890883872 cites W2013552107 @default.
• W2890883872 cites W2013667564 @default.
• W2890883872 cites W2014227513 @default.
• W2890883872 cites W2015301137 @default.
• W2890883872 cites W2017523852 @default.
• W2890883872 cites W2017629806 @default.
• W2890883872 cites W2018658070 @default.
• W2890883872 cites W2022401640 @default.
• W2890883872 cites W2023403873 @default.
• W2890883872 cites W2024371461 @default.
• W2890883872 cites W2024649457 @default.
• W2890883872 cites W2025019850 @default.
• W2890883872 cites W2031522244 @default.
• W2890883872 cites W2032618582 @default.
• W2890883872 cites W2035463039 @default.
• W2890883872 cites W2040607890 @default.
• W2890883872 cites W2041927436 @default.
• W2890883872 cites W2044358900 @default.
• W2890883872 cites W2046991340 @default.
• W2890883872 cites W2047080166 @default.
• W2890883872 cites W2048431097 @default.
• W2890883872 cites W2049487316 @default.
• W2890883872 cites W2050302634 @default.
• W2890883872 cites W2051610136 @default.
• W2890883872 cites W2051660323 @default.
• W2890883872 cites W2052105948 @default.
• W2890883872 cites W2052635964 @default.
• W2890883872 cites W2055195829 @default.
• W2890883872 cites W2056579562 @default.
• W2890883872 cites W2061398787 @default.
• W2890883872 cites W2067298607 @default.
• W2890883872 cites W2070578512 @default.
• W2890883872 cites W2075765508 @default.
• W2890883872 cites W2075944052 @default.
• W2890883872 cites W2082655573 @default.
• W2890883872 cites W2083636637 @default.
• W2890883872 cites W2085364923 @default.
• W2890883872 cites W2086276948 @default.
• W2890883872 cites W2089119578 @default.
• W2890883872 cites W2097195468 @default.
• W2890883872 cites W2099269088 @default.
• W2890883872 cites W2099705687 @default.
• W2890883872 cites W2100207436 @default.
• W2890883872 cites W2100240091 @default.
• W2890883872 cites W2105663228 @default.
• W2890883872 cites W2106153337 @default.
• W2890883872 cites W2110808938 @default.
• W2890883872 cites W2113508115 @default.
• W2890883872 cites W2113851415 @default.
• W2890883872 cites W2114886288 @default.
• W2890883872 cites W2116006387 @default.
• W2890883872 cites W2116049831 @default.
• W2890883872 cites W2118745447 @default.
• W2890883872 cites W2120877488 @default.
• W2890883872 cites W2121272532 @default.
• W2890883872 cites W2124221494 @default.
• W2890883872 cites W2136615666 @default.
• W2890883872 cites W2142324027 @default.
• W2890883872 cites W2142521284 @default.
• W2890883872 cites W2143342386 @default.
• W2890883872 cites W2144429223 @default.
• W2890883872 cites W2146917737 @default.
• W2890883872 cites W2157117851 @default.
• W2890883872 cites W2157683852 @default.
• W2890883872 cites W2161298562 @default.
• W2890883872 cites W2163611479 @default.
• W2890883872 cites W2163951810 @default.
• W2890883872 cites W2164777277 @default.
• W2890883872 cites W2165338442 @default.
• W2890883872 cites W2169937173 @default.

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