Purpose: To investigate how patients undergoing elective cardiac procedures obtain information and whether information-seeking behavior is associated with decision-making processes.
Method: We analyzed data from a national cross-sectional survey of about the decision-making of Medicare beneficiaries who had an elective percutaneous coronary intervention or coronary artery bypass surgery in 2008. The survey included questions about information sources used (physician, media, family and friends, internet) and decision-making processes. We determined the proportion of patients using each source. We also performed multivariate logistic regression to determine the association between patients who considered a specific source of information important and aspects of the decision-making process.
Result: The survey response rate was 78% (1110/1421); after exclusions, 927 patients were included in the analysis. The majority of patients (93.3%) obtained information from their physician, and 91.1% of those patients felt that their physician was a “very” or “extremely” important source of information. Fewer patients obtained information from family and friends (72.9%), the media (44.4%), or the internet (12.1%). In terms of the decision-making process, patients who reported that their doctor was their only information source were much less likely to be asked their preference for treatment (OR 0.43, 95% CI 0.24-0.80) and were more than twice as likely to report a decision primarily made by the physician (OR 2.35, 95% CI 1.57-3.52). Conversely, patients who reported that the family or the internet were important sources of information were much more likely to be asked their preference for treatment (OR 1.76, 95% CI 1.21-2.55 [family]; OR 2.45, 95% CI 1.28-4.71 [internet]), and much less likely to report that mostly the doctor made the decision (OR 0.56, 95% CI 1.21-2.55 [family], OR 0.35, 95% CI 0.13-0.91 [internet]) than patients who did not report that these sources were important sources of information.
Conclusion: Among Medicare patients who underwent elective cardiac procedures, patients who sought and used information from sources other than the physician were more likely to report being involved in the decision-making process. These results suggest that patients who rely on the physician alone for information may either not be provided with sufficient information or the opportunity to actively engage in the decision-making process, or do not wish to do so.
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