What are patient preferences, and why are they important?

Patient preferences refer to individuals' choices about healthcare and medical treatment. Their decisions may be based on their beliefs, values, or experiences. 

Healthcare providers usually employ various techniques to elicit patient preferences, such as surveys, focus groups, and interviews. Also referred to as patient decision aids, the resources can be web-based, printed, or educational videos. 

There's increased emphasis on incorporating patient preferences in healthcare decision-making. The concept acknowledges that disease trajectories and symptom progression differ from case to case. 

Patients may have differing desires on issues such as type and intensity of treatment or provider's experience level. That’s why it’s important to understand and incorporate their needs. 

Let’s take an in-depth look into patient preferences, including the benefits, challenges, and some patient preferences examples.  

Healthcare stakeholders (patient organizations, payers, regulators, etc.) are increasingly pushing for patient involvement in treatment and care options decisions. This is critical with multiple treatment paths. 

For instance, there may be multiple screening options for a condition or various treatment approaches, such as different surgeries, medications, or therapies.

While people may primarily base their decisions on their beliefs, values, and experiences, providers can offer decision aids to help them reach more informed and concrete decisions.

For instance, they could survey the patients to understand their needs or set up patient and family advisory councils (PFACs). The councils consist of caregivers, family members, and patients who have received care at the facility. 

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Multiple factors affect patient preferences in different settings. 

One qualitative study studied 22 patients and 22 healthcare professionals in an orthopedic rehabilitation setting. The factors influencing the patients’ decisions for virtual consultations included:

• Situation of care: Patient's understanding of their clinical status, treatment requirements, and care pathway

• Expectations of care: Based on the patient's preference for contact, previous care, psychological status, and perceived requirements

• Demands on the patient: Patient's social situation and choice consequences

• Care resources allocation capacity: Financial, social, healthcare, and infrastructural resources

Another study interviewed 54 veterans. It found their willingness to participate in decision-making for their mental health care fluctuated over time and depended on the context. 

According to the study, the following factors influenced their involvement:

• Patient-provider relationship

• Fear of being judged

• Perceived inadequacy 

• History of substance abuse

A ScienceDirect review of thirty-three studies looked at what informs patients' preferences. It categorized the factors into:

• Motivational 

• Cognitive

• Individual differences

• Emotion and mood

• Health beliefs

In addition to care-oriented patient preferences, patient access schemes (PAS) can elicit patient decisions using various methods, such as: 

• Surveys

• Focus groups

• Experiments

• Interviews

• Multi-criteria decision analysis

PAS are agreements between stakeholders (payers and manufacturers) to improve the availability and affordability of medicines to patients. 

Involving patients in their healthcare decision-making contributes to positive results. When providers suggest medical care that matches patients' desires, they're more willing to initiate and engage in the treatment. 

Research supports this approach and suggests incorporating patient preferences improves treatment initiation and outcomes.

Incorporating patient preferences has numerous benefits. It ensures the treatment reflects their values, experiences, and expectations, which goes a long way in enhancing its effectiveness. 

Here are a few benefits:

Enhanced patient cooperation

Involving patients in decisions about their care options motivates them to be more engaged and consistent in the treatment. This crucial factor boosts their chances of recovery.

Improved patient satisfaction and clinical outcomes

Patients involved in their treatment journey understand their condition better and the requirements for effective care. As a result, they're more satisfied with the clinical outcomes.

Reduced costs

Involving patients in healthcare decision-making can also reduce costs. When the provider and patient discuss the risks and benefits of each option, they can agree on the most cost-effective approach and reduce overall costs.

More informed treatment choices

Patients who have undergone treatment for a while may know what works best for them.

Better communication

Inviting patients' input in their care preferences fosters better communication, which increases transparency and nurtures patient-physician trust.

The concept of incorporating patient preferences is beneficial in many ways. However, notable challenges stand in the way, such as:

Biased providers

If providers perceive patients as ignorant and incapable of making medical choices, they may be reluctant to consider their input. Similarly, if the provider comes off as too knowledgeable, the patient might feel inadequate and shy away from airing their desires for fear of being judged.

Decision aid limitations

Decision aids may impact patient participation if they impose barriers to effective communication and capturing patient decisions. For instance, if they do not consider the patients' different literacy levels, some might have challenges expressing their desires. 

Time constraints

Incorporating patients' decisions may require stretched-out consultations. Some providers consider these lengthy, slowing down the treatment process. 

Medical malpractice lawsuits

As much as involving patients in their treatment is essential, providers must guide them in making choices that are in their best interests. 

A provider can be liable for medical malpractice if a patient opts for a procedure or care plan that does not adequately cater to their healthcare needs.

Reimbursement issues

Shared decision-making involves lengthy consultations between physicians and patients. Some payers do not reimburse providers for time spent during these types of consultations, a factor that may discourage acceptance of the concept in healthcare settings. 

Inability to elicit patient preferences

It's easier for physicians to elicit preferences from patients they know well than new ones. Some physicians may have difficulty engaging new patients in decision-making if they lack the necessary skills to win their trust.

Patients’ unwillingness to be involved

Some patients might feel inadequate to make informed decisions and unwilling to participate in the process. 

Alternative information sources

If patients have gathered information on treatment options from poor sources, a physician may have challenges countering it.  

Accommodating patient preferences in healthcare decision-making is an excellent step toward shaping positive patient experiences. 

With the increased emphasis on patient involvement from stakeholders, healthcare providers should encourage shared decision-making. 

Different factors may affect a patient's preferences, and considering them enhances patient satisfaction. It also encourages treatment participation, leading to improved clinical outcomes. 

Other benefits of shared decision-making include reduced costs, better communication, and more informed treatment choices. 

However, you must be aware of potential challenges and find ways to overcome them.

Where there are multiple options for treatment or care plans, the decision should incorporate the patient's preference. 

Involving them ensures a more informed decision based on their values and past experiences, enhancing clinical outcomes. 

For instance, incorporating a patient's end-of-life care wishes can inform a healthcare provider's decision on whether to put them on life support.

You should incorporate a patient's preferences whenever the treatment or care plan provides multiple options. 

To ease their decision-making, you may employ various decision aids such as surveys, interviews, or patient and family advisory councils. 

However, as much as incorporating their decision is essential, you should ensure it's the best option based on their situation. Otherwise, you could be liable for medical malpractice if their treatment choice doesn't adequately cater to their healthcare needs. 

Patient autonomy in decision-making promotes an individual's healthcare choice independence, free from undue pressure from the providers. 

It restricts healthcare providers from imposing treatment on patients. The patient reserves the right to express their desires about treatment choices, especially where the outcomes may vary. 

Some common patient preferences include:

• Choosing medication or psychotherapy

• The decision to stay in or out of hospital

• Preference for one medication over another based on side effects

• The choice to extend life

• Preference for provider's experience level or gender