Patient preferred role in medical decision-making in Mexico City with different chronic diseases.

Background: Patient preferences about their role in decision-making in medical practice are a very important phenomenon, especially since patient participation allows decision-making to be more responsive to their needs and improves the quality of care.

Objective: To evaluate the proportion of patients with preferences toward an active, passive, or shared role in medical consultation in a sample of patients with chronic diseases who attend family medicine and general hospital level of care and to explore the relationship of preferences with sociodemographic and clinical variables.

Methods: Participants were recruited from their scheduled consultation in August, 2019, at one family medicine and one general hospital of the Mexican Institute of Social Security. People >18 years of age with different chronic disease diagnoses were surveyed. The Control Preferences Scale was applied to identify the participants' preferred role in decision-making related to medical care. The evaluation of health status and health-related quality of life was included. Multivariate analyses determined the predictors of participation preferences in decision-making.

Results: A total of 530 patients participated. Most preferred the passive role (47.7%), followed by the shared role (27.7%) and the active role (24.5%). Age influenced preferences; participants ≥45 years preferred a shared role. Patients who reported poorer quality of life preferred the shared role in decision-making.

Conclusion: The study showed that patients with chronic diseases prefer to leave the decisions to doctors. Only patients <45 years with a good quality of life had a greater preference for participation in decision-making.