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Anticipated Regret Associated With Treatment Decisions for Agitated Dementia Patients

Department of Psychiatry and Behavioral Medicine, Bowman Gray School of Medicine.

Anticipation of regret for choosing the wrong option may directly affect physicians' choice of treatment. As part of a pilot survey of physician practices for agitated dementia patients, we asked geriatric psychiatrists, primary care physicians, and neurologists to estimate the degree of anticipated regret that they might experience in response to a series of brief case vignettes describing typical treatments and outcomes for agitated dementia patients. Eight written vignettes described physician action (ordering vs. not ordering), type of intervention (haloperidol vs. physical restraints), and outcome of the intervention (adverse patient outcome vs. adverse staff outcome). Regret was measured by using a five-point Likert scale. A full factorial regression model found that "not ordering" actions were associated with more regret than "ordering" actions, regardless of specialty, intervention, or outcome. Also, geriatric psychiatrists, compared with the other physician groups, expressed the least regret for ordering (and the most for not ordering) haloperidol.