Chapter 2 34 3. Results 3.1 Study participants Eleven physicians participated in this study, including 4 residents (educational year 3-6) and 7 specialists from different areas of specialization (nephrology, vascular medicine, immunology, endocrinology, gastroenterology). The majority were female (8/11, 73%), responsible for 71% of all consultations in this study. One physician was not able to participate due to lack of time. Between October 2018 and February 2020, a total of 185 patients participated in the study. Figure 1 shows a diagram of the patient-participant flow. The physicians’ training took place when 77 patients were included (33% of the attempted total sample size). Table 1 shows the baseline characteristics of the patients stratified by intervention group. The overall median age was 58 years (IQR 50-68), 60% were men, and the median CCI was 3.0 (IQR 1.0-5.0). A total of nine patients were lost to follow-up. These were equally divided amongst the four groups and the characteristics we had from these patients (age, gender and CCI) were similar to the overall values. 3.2 Patient satisfaction, patient-doctor relationship and shared decision making Table 2 shows the mean patient satisfaction, patient-doctor relationship and shared-decision-making stratified by intervention group. The number of patient-reported care decision discussions during the outpatient clinic visit and in which a decision was made are shown as well. Only 45/161 (28%) patients reported to have discussed care decisions during the outpatient clinic visit, of which 25 (56%) made a decision. After adjusting for patient-related (age, gender, quality of life, CCI) and physician-related (specialist/resident, gender) confounders, no statistically significant association between conversation aid and physician’s training and mean satisfaction score was found (effect sizes -0.14 (95% CI -0.56 to 0.27) for conversation aid; -0.04 (95% CI -0.48 to 0.40) for physician’s training). Similarly, for the secondary outcomes, patient-doctor relationship (effect sizes -0.45 (95% CI -2.85 to 1.95) for conversation aid; 1.28 (95% CI -1.04 to 3.60) for physician’s training) and shared-decision-making (-0.01 (95% CI -5.96 to 5.94) for conversation aid; -0.23 (95% CI -8.89 to 8.42) for physician’s training) no statistically significant association was found
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