Interventions for improving patients’ trust in doctors and groups of doctors

Background: Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated s...

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Main Authors: Rolfe, Alix, Cash-Gibson, Lucinda, Car, Josip, Sheikh, Aziz, McKinstry, Brian
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2014
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Online Access:https://hdl.handle.net/10356/104143
http://hdl.handle.net/10220/19445
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Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-104143
record_format dspace
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic DRNTU::Science::Medicine
spellingShingle DRNTU::Science::Medicine
Rolfe, Alix
Cash-Gibson, Lucinda
Car, Josip
Sheikh, Aziz
McKinstry, Brian
Interventions for improving patients’ trust in doctors and groups of doctors
description Background: Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated search was required to find out if there is further evidence of the effects of interventions that may improve trust in doctors or groups of doctors. Objectives: To update our earlier review assessing the effects of interventions intended to improve patients' trust in doctors or a group of doctors. Search methods: In 2003 we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, Health Star, PsycINFO, CINAHL, LILACS, African Trials Register, African Health Anthology, Dissertation Abstracts International and the bibliographies of studies selected for inclusion. We also contacted researchers active in the field. We updated and re-ran the searches on available original databases (Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 2, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (Ebsco)) as well as Proquest Dissertations and Current Contents for the period 2003 to 18 March 2013. Selection criteria: Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series of interventions (informative, educational, behavioural, organisational) directed at doctors or patients (or carers) where trust was assessed as a primary or secondary outcome. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Where mentioned, we extracted data on adverse effects. We synthesised data narratively. Main results: We included 10 randomised controlled trials (including 7 new trials) involving 11,063 patients. These studies were all undertaken in North America, and all but two involved primary care. As expected, there was considerable heterogeneity between the studies. Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style. Additionally, several different measures of trust were employed. Authors' conclusions: Overall, there remains insufficient evidence to conclude that any intervention may increase or decrease trust in doctors. This may be due in part to the sensitivity of trust instruments, and a ceiling effect, as trust in doctors is generally high. It may be that current measures of trust are insufficiently sensitive. Further trials are required to explore the impact of doctors' specific training or the use of a patient-centred or decision-sharing approach on patients' trust, especially in the areas of healthcare provider choice, and induction into healthcare organisation. International trials would be of particular benefit. The review was constrained by the lack of consistency between trust measurements, timeframes and populations.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Rolfe, Alix
Cash-Gibson, Lucinda
Car, Josip
Sheikh, Aziz
McKinstry, Brian
format Article
author Rolfe, Alix
Cash-Gibson, Lucinda
Car, Josip
Sheikh, Aziz
McKinstry, Brian
author_sort Rolfe, Alix
title Interventions for improving patients’ trust in doctors and groups of doctors
title_short Interventions for improving patients’ trust in doctors and groups of doctors
title_full Interventions for improving patients’ trust in doctors and groups of doctors
title_fullStr Interventions for improving patients’ trust in doctors and groups of doctors
title_full_unstemmed Interventions for improving patients’ trust in doctors and groups of doctors
title_sort interventions for improving patients’ trust in doctors and groups of doctors
publishDate 2014
url https://hdl.handle.net/10356/104143
http://hdl.handle.net/10220/19445
_version_ 1683494470456180736
spelling sg-ntu-dr.10356-1041432020-11-01T05:30:52Z Interventions for improving patients’ trust in doctors and groups of doctors Rolfe, Alix Cash-Gibson, Lucinda Car, Josip Sheikh, Aziz McKinstry, Brian Lee Kong Chian School of Medicine (LKCMedicine) DRNTU::Science::Medicine Background: Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated search was required to find out if there is further evidence of the effects of interventions that may improve trust in doctors or groups of doctors. Objectives: To update our earlier review assessing the effects of interventions intended to improve patients' trust in doctors or a group of doctors. Search methods: In 2003 we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, Health Star, PsycINFO, CINAHL, LILACS, African Trials Register, African Health Anthology, Dissertation Abstracts International and the bibliographies of studies selected for inclusion. We also contacted researchers active in the field. We updated and re-ran the searches on available original databases (Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 2, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (Ebsco)) as well as Proquest Dissertations and Current Contents for the period 2003 to 18 March 2013. Selection criteria: Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series of interventions (informative, educational, behavioural, organisational) directed at doctors or patients (or carers) where trust was assessed as a primary or secondary outcome. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Where mentioned, we extracted data on adverse effects. We synthesised data narratively. Main results: We included 10 randomised controlled trials (including 7 new trials) involving 11,063 patients. These studies were all undertaken in North America, and all but two involved primary care. As expected, there was considerable heterogeneity between the studies. Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style. Additionally, several different measures of trust were employed. Authors' conclusions: Overall, there remains insufficient evidence to conclude that any intervention may increase or decrease trust in doctors. This may be due in part to the sensitivity of trust instruments, and a ceiling effect, as trust in doctors is generally high. It may be that current measures of trust are insufficiently sensitive. Further trials are required to explore the impact of doctors' specific training or the use of a patient-centred or decision-sharing approach on patients' trust, especially in the areas of healthcare provider choice, and induction into healthcare organisation. International trials would be of particular benefit. The review was constrained by the lack of consistency between trust measurements, timeframes and populations. Published version 2014-05-26T02:17:16Z 2019-12-06T21:27:25Z 2014-05-26T02:17:16Z 2019-12-06T21:27:25Z 2014 2014 Journal Article Rolfe, A., Cash-Gibson, L., Car, J., Sheikh, A., & McKinstry, B. (2014). Interventions for improving patients' trust in doctors and groups of doctors. Cochrane Database of Systematic Reviews, 2014(3), CD004134. 1469-493X https://hdl.handle.net/10356/104143 http://hdl.handle.net/10220/19445 10.1002/14651858.CD004134.pub3 en Cochrane database of systematic reviews © 2014 The Cochrane Collaboration. This paper was published in Cochrane Database of Systematic Reviews and is made available as an electronic reprint (preprint) with permission of The Cochrane Collaboration. The paper can be found at the following official DOI: http://dx.doi.org/10.1002/14651858.CD004134.pub3.  One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper is prohibited and is subject to penalties under law. 66 p. application/pdf