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Leave It to Doctors Please, They Know Better

by Gopalan on Feb 27 2008 12:19 PM

Leaving it to doctors might be the best solution, it looks like. Taking active interest in one’s own treatment might not be of all that help, though that could accord some satisfaction.

At least among the chronically ill, those who choose to be highly involved in their medical treatment actually fare less well than those who defer to their doctors, finds a new study.

University of Iowa researchers in the US tracked 189 veterans with high blood pressure over a 12-month period in 2004. They compared those patients who wanted an "active" role in their treatment — one in which they made more decisions about the drug and lifestyle changes they made — and those patients who wanted a less active role.

The study participants were 97 per cent men with an average age of 65.8 years.

Researchers found that those patients who were more active in their approach had higher blood pressure and cholesterol in the year of study than the more passive participants. They had an average blood pressure of 141 over 70 and low-density lipoprotein cholesterol of 122. In contrast, the more passive participants had a lower blood pressure score of 137 over 72 and a cholesterol level of 92.

"The intuitive assumption is that the more involved people are with their health, the better they'll be at managing chronic conditions," said Austin Baldwin, a post-doctoral fellow in the Center for Research in the Implementation of Innovative Strategies in Practice at the VA Iowa City Health Care System, in a release.

"We found evidence to the contrary. Those who preferred a more 'patient-centred' or active role actually had higher blood pressure and lipid levels. Those who preferred a 'provider-centred' approach, in which the doctor is more authoritative, did better at managing their blood pressure and lipid levels."

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The authors theorize that patients who sought a more active role in their treatment may have been less satisfied with the drug regime their doctors prescribed and were less inclined to follow it diligently.

The authors say research into patients' preferences concerning their treatment options is key, as it can help physicians tailor treatment programs to their needs and increase their chance of success.

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"The upshot of this research is that there isn't a one-size-fits-all approach," said Baldwin. "It's nice to think if we give everyone Treatment X, they're all going to do well. But individual differences and preferences are important, and the value of studying this is to understand how these preferences can influence treatment adherence and ultimately influence people's health."

The study is published this week in the Annals of Behavioral Medicine.

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