Trust in the health-care provider–patient relationship: a systematic mapping review of the evidence base

Purpose Trust is important for patients and may be used as an indicator and potential ‘marker’ for how patients evaluate the quality of health care. The review aimed to classify the current evidence base on trust in the patient–provider relationship in order to identify strengths and weaknesses and to point towards areas for future research.

Data sources Nine electronic databases were searched from 2004 onwards using text and subject heading keywords relating to ‘trust’ and ‘health care’ and ‘relationships’.

Study selection Abstracts were identified for empirical studies carried out in health-care settings that explicitly examined trust or reported trust-related findings as a secondary outcome.

Data extraction Two review authors assessed the relevance of abstracts and extracted data relating to year published, country of study, clinical speciality, study design and participants.

Results of data synthesis Five hundred and ninety-six abstracts were included. Most reported on patients' trust in providers; were carried out in the USA; collected data in family care or oncology/palliative care settings; used questionnaires and interviews and elicited patients' perspectives. Only one study explicitly set out to examine providers' trust in patients and <5% of included studies reported on providers' trust in patients.

Conclusion Providers' trust in patients remains a neglected area on the trust research agenda. Empirical studies examining the factors that influence providers' trust in patients and how this might affect the quality of care and patient health-related behaviours are urgently needed to readdress this imbalance. Further exploration of this area using observational methods is recommended.