European Commission publishes Eurobarometer Qualitative Study on Patient Involvement

Tuesday 15 May 2012

On 15 May 2012, the European Commission (DG Sanco) published Eurobarometer’s Qualitative Study on Patient Involvement. This study explored views on patient involvement in healthcare across fifteen European Member States (Austria, Belgium, Czech Republic, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Poland, Romania, Spain, Slovakia and the United Kingdom).

In-depth interviews were carried out with five healthcare practitioners and ten patients in each country. The key conclusions were:

• The term “Patient involvement” was not clearly understood by either patients or practitioners and often meant different things to different people.
• Practitioners and patients alike see the benefits of patients being more engaged and taking more responsibility for their health. However, it was difficult for either healthcare professionals or patients to identify the more concrete benefits of involvement in healthcare process.
• Communication was central to the idea of patient involvement for many.
• Many patients described a “traditional doctor-patient relationship”, where the doctor was seen as beyond questioning and patients felt uncomfortable giving feedback. Where the relationship was seen to be on a more level arrangement, patients found it easier to provide feedback.
• Healthcare professionals tended to be satisfied with the current relationship they have with patients but patients wanted a more balanced relationship (this was often described in terms of information). Patients did not want to be responsible for decision-making, they wanted to be able to ask questions and understand how decisions were made.
• Choice was also a key aspect of patient involvement for some patients.
• The internet as a source for more information about symptoms and healthcare was generally felt to be the area where there has been the most significant development. This was seen as positive by patients but was seen more ambivalently by some practitioners. More regulated information was considered as a useful safeguard against the risk of “internet misdiagnosis” by patients.
• Practitioners saw the benefits of "patient involvement" as more motivated and engaged patients, with increased understanding. Patients saw the benefits as having more information and options with regard to treatment, and a more open dialogue with practitioners where communication was improved and questions could be asked.
• The two key risks of “patient involvement” were perceived to be the resourcing requirements needed (e.g. additional time and staffing) and the negative impact it might have on the patient/doctor relationship.
• Some general differences emerged between different types of respondent: chronically ill patients tended to have more experience in self-monitoring and other aspects and often had a more tangible understanding of patient involvement.
• Younger patients and those with a better education had higher expectations of their own involvement and tended to be less reluctant to question decisions made about their own healthcare.

Although there were similar themes across all countries, there were differences between certain countries. For example, in the Eastern European countries (Czech Republic, Hungary, Latvia, Poland, Romania, Slovakia) and to a lesser extent Greece, the current state of the healthcare infrastructure was often described as less adequately funded and there tended to be a less balanced relationship between doctors and patients. In these countries, patients tended to have less understanding of what patient involvement might involve and there was more reluctance to have a more interactive relationship with their healthcare provider.

The study findings indicate that patient involvement, in the sense of having patients at the heart of the healthcare process, seems poorly understood by many professionals and patients across the EU, with only limited concrete ideas and activities which substantiate the concept in real healthcare practices.

This research was qualitative in nature and is not intended to be representative of the views of either practitioners or patients in the participating countries. Conclusions reflect the experience and views of those who took part in the study.

http://ec.europa.eu/health/healthcare/docs/eurobaro_patient_involvement_2012_en.pdf