Keys to help patients make better health decisions

More payors are calling on hospitals to provide patient-centered care and get patients more involved in their treatment, since better engagement often leads to improved health outcomes. Part of this process involves giving patients the information they need to make the best decisions about their health. 

Doctors must communicate health information to patientsYour providers may feel that just presenting patients with their options is enough for them to make rational decisions about their health care. But there are several other factors to consider – including the process behind decision making for many adults.

As discussed in a news release, a new research paper from the Gerontological Society of America sheds some light on the process of medical decision making for older adults, and how providers can overcome some common misconceptions that may cause patients to make irrational decisions about their health and treatment.

Mental biases hurt decisions

Often, instead of looking at the facts presented, patients make decisions based on factors such as internal biases. According to the research paper, this can manifest itself in a variety of ways.

Some common types of biases that can influence patients’ healthcare decisions include:

Availability. Patients have a tendency to overestimate the likelihood of an event occurring based on how easily information is available about it, particularly stories about negative effects or deaths. For example, due to hearing constant coverage from news reports, elderly patients may be more worried about contracting Zika than the flu. So they may ask about whether vaccines are available for Zika, but ignore the recommendation to get a flu vaccine. Providers can overcome this bias by providing patients with clear, accurate information about their actual risks for contracting these illnesses, along with emphasizing the negative impact of not receiving vaccines for conditions like the flu.

Anchoring. With the anchoring effect, one number skews how patients estimate other numbers. This often comes up regarding medication dosing. A person may remember receiving a prescription for 800 mg of a pain medication in the past. So they’ll self-adjust the dosing of all future prescriptions up or down, depending on their perception of the pain, using 800 mg as their mental “anchor.” This can lead to overdosing or underdosing of medications, which may cause serious harm to patients. To overcome anchoring, providers must acknowledge that the dosage may have been prescribed to the patient in the past, but it’s not appropriate to change the current recommended dose of a medication based on a previous one since the person’s medical condition has changed. It’s also important for providers to emphasize the negative effects of not taking medications as prescribed.

Omission. Omission bias refers to people’s tendency to prefer inaction (omission) to an actual action (commission), even if inaction is more likely to cause serious harm. Omission bias is especially apparent when either choice can cause a degree of harm. For example, a patient with atrial fibrillation may refuse to take warfarin because of concern over the risk of hemorrhagic stroke, despite the fact that without warfarin, the risk of ischemic stroke is much greater than any negative effects of the medication. The best way to overcome omission bias is to clearly let patients know how much worse inaction can be for their health, focusing on the severity of complications for the long term.

Sunk cost. A sunk cost is an unrecoverable use of money, time or effort. People will often stick to a course of action that isn’t working to try and avoid sunk costs – and that can have a negative impact on their health. A patient may want to continue using a medication, supplement or course of treatment because they’ve already invested time and money into it, and they’ll often try to stick with it whether or not it’s effective. In this case, providers can help patients acknowledge and come to terms with the loss, while letting them know that continuing a course of action that isn’t working will only lead to more waste – and could even put their health in danger.

Ultimately, patients are more likely to follow a provider’s recommendations and plan of care if they fully understand the risks of noncompliance and the benefits of sticking to their treatment plans. And if providers give them this information up front in a direct manner, they can make decisions that promote better health outcomes.