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UK lags behind other countries in patient involvement, says report

Picker Institute says 'paternalistic attitude' of doctors prevents patients from taking active role in their healthcare

The paternalistic attitude of UK health professionals is preventing patients from taking an active role in managing their healthcare, according to a report from medical research charity, the Picker Institute.

The study found that in terms of patients being involved in decisions about their healthcare, the UK lags behind other developed nations such as Australia, Canada, New Zealand, Germany and the US.

The findings could not have come at a worse time for the Department of Health, with current government reforms designed to create a more patient-led NHS.

Researchers analysed data from international patient surveys comparing performance in relation to six indicators of patient engagement and how well health professionals are encouraging them to take a more active role in their own healthcare.

These included: quality of doctor-patient communication; access to alternative sources of information and advice; and how well the risks associated with treatment were explained. The report said the UK scored worst in almost all of the areas examined.

The study found that British patients are the least likely to receive advice from doctors on disease prevention and lifestyle changes while patients undergoing surgery in UK hospitals are less likely to have access to information about their surgeon.

Fewer UK patients were involved in treatment decisions that those of other countries, and they were also less likely to take part in a medication review or be given information about possible side effects of their treatments.

In terms of self-care and self-management of conditions, the UK also fared badly. British patients were less likely to be given clear instructions on what to do about monitoring and managing their treatment than in other countries, with the exception of the US. Meanwhile, less than one in five British people with chronic conditions had been given a self-management plan.

Angela Coulter, chief executive of the Picker Institute and lead author of the report, called for a major change in the way healthcare professionals work with patients: ìThe policy direction for patient and public involvement is clear, but the sector must be bolder about challenging and modernising its own culture and attitudes.

ìProfessionals should be encouraged to recognise their responsibility to promote health literacy and disease prevention, support self-care and self-management and involve patients in decisions that affect them,î she added.

Cherill Hick, editor of BestTreatments, the British Medical Journal's health information service, described the findings as ìextremely worryingî.

ìThe report states that most patients want information about the pros and cons of treatment options, including reliable, evidence-based information about the likelihood of benefits and harms associated with the treatment or procedure that the doctor is recommending,î she said.

30th September 2008

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