The Association of Patient Chronic Disease Burden and Self-Management Requirements With Shared Decision Making in Primary Care Visits

Background:Shared decision making (SDM) is associated with positive health outcomes and may be particularly relevant for patients with chronic disease.Objectives:To investigate whether (1) patients with chronic diseases, particularly those requiring self-management, are more likely to engage in SDM behaviors than patients without chronic diseases and (2) patients with chronic diseases are more likely to have their physicians engage them in SDM.Design:A cross-sectional study of patients who were enrolled in a randomized controlled trial to improve patient–physician communication.Participants:Adult patients with hypertension at community health clinics in Baltimore, Maryland.Approach:We used multivariable regression models to examine the associations of the following predictor variables: (1) chronic disease burden and (2) diseases requiring self-management with the following outcome variables measuring SDM components: (1) patient information sharing, (2) patient decision making, and (3) physician SDM facili...