AB087. SOH23ABS_113. Trust in clinical practice: a systematic review

Background: This systematic review is an attempt to gain a better understanding of the true importance of trust in clinical practice by looking at how it is formed, how it affects clinical practice, and how to improve it.

Methods: A review of the literature was performed to identify research evaluating the importance of trust in the doctor-patient relationship. After thorough screening and removal of duplicates, 21 articles were used in the literature review.

Results: The classifying themes that emerged in the selected articles were ‘What makes trust’ and ‘Effects of trust’. The theme ‘What makes trust’ garnered two subthemes: ‘Impact of doctor-patient relationship on trust’ and ‘Impact of shared decision-making on trust’. Further, overarching themes were ‘Traits of trust’, ‘Mistrust and barriers to trust’, ‘Positive effects of trust’, and ‘Effects of a lack of trust’. We found the best way to improve trust was to improve communication between the patient and the doctor. Additionally, we found that the biggest barrier to a trusting doctor-patient relationship was a stigmatised condition, followed by a perception of a financially motivated doctor. Finally, we found that a lack of trust can prevent patients from seeking and receiving proper treatment.

Conclusions: With a better understanding of how trust is built and the extent of the role it plays in clinical practice, we hope that this growing knowledge can improve the practice of many doctors in the future. More research must be done in this area, especially focusing on vulnerable and stigmatised populations such as chronic pain patients.

Keywords: Clinical practice; doctor; doctor patient relationship; patient; trust