Cost and Insurance Coverage Lacking in Physician-Patient Interactions

Paul Barr MSc, PhD Assistant Professor of Health Policy and Clinical Practice The Dartmouth Institute for Health Policy & Clinical Practice

Dr. Paul Barr

MedicalResearch.com Interview with:
Paul Barr MSc, PhD
Assistant Professor of Health Policy and Clinical Practice
The Dartmouth Institute for Health Policy & Clinical Practice 

Medical Research: What is the background for this study? What are the main findings?

Dr. Barr: I belong to the Preference Laboratory, a group of researchers in The Dartmouth Institute for Health Policy & Clinical Practice, who focus on research to improve patient engagement in their health care. One of our areas of interest is mental health, especially depression given the high and increasing prevalence of this condition in America and worldwide. Previous research has found that individuals with depression are not fully engaged in the treatment decision making process and may not be aware of their options. Decision aids are short tools that provide information on available treatment options and information about those options that is important to patients and clinicians, which can facilitate greater patient engagement through shared decision making.  To develop these tools, it is important to identify the information important to patients and clinicians when making treatment decisions.

By conducting a national survey of individuals with depression and clinicians who treat depression across the US, we found that patients and clinicians felt that the effectiveness of treatment, potential side-effects and time to recovery were important to discuss. However, where patients wanted to know about about cost and insurance coverage of treatment, clinicians did not focus on these priorities. Yet when asked to take the patient’s perspective, clinicians had the same priorities as patients, including cost and insurance coverage. In addition, only 18% of patient respondents reported experiencing a high level of shared decision making on the CollaboRATE survey (www.collaboratescore.org). 

Medical Research: What should clinicians and patients take away from your report?

Dr. Barr: Clinicians know their patients! But they need to find a way to include information important to patients, especially cost and insurance coverage, when discussing treatment options with patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Barr: We are currently developing an Option Grid(TM) decision aid (www.optiongrid.org) for depression that is designed to be used during the clinic visit. This decision aid can streamline the conversation between clinician and patient regarding treatment options and increase the level of shared decision making patients experience.

MedicalResearch: Is there anything else you would like to add:

Dr. Barr: The inclusion of patient partners and clinicians in our research has been vital. They add a depth of knowledge that the literature just cannot convey.

Citation:

Paul J Barr, Rachel C Forcino, Manish Mishra, Rachel Blitzer, Glyn Elwyn.
Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression. BMJ Open, 2016; 6 (1): e009585
DOI: 10.1136/bmjopen-2015-009585

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Paul Barr MSc, PhD (2016). Cost and Insurance Coverage Lacking in Physician-Patient Interactions MedicalResearch.com

Last Updated on January 12, 2016 by Marie Benz MD FAAD