| Title |
Patient-provider concordance in the perception of illness and disease: a cross-sectional study among multimorbid patients and their general practitioners in Switzerland
|
|---|---|
| Published in |
Patient preference and adherence, August 2017
|
| DOI | 10.2147/ppa.s137388 |
| Pubmed ID | |
| Authors |
Stefan Neuner-Jehle, Stefan Zechmann, Daniela Grundmann Maissen, Thomas Rosemann, Oliver Senn |
| Abstract |
Multiple chronic health conditions are leading to multiple treatment procedures and polypharmacy. Prioritizing treatment according to patients' needs and preferences may be helpful for deprescribing. Thus, for improving health care, it is crucial for general practitioners (GPs) to perceive the chief complaints (CCs) of patients. The primary aim of this study was to investigate the patient-provider concordance of CCs and the secondary aim was to investigate the concordance between CCs and diagnosis, in a sample of Swiss multimorbid patients. A cross-sectional analysis based on a cluster randomized controlled trial (RCT) among 46 GPs, recruited between March 2015 to July 2016, and 334 multimorbid patients (≥60 years taking ≥5 drugs for at least 6 months) in Northern Switzerland was performed. CCs listed by GPs and by patients (n=128) were classified according to the International Classification of Primary Care, version 2 (ICPC-2) coding system on chapter and component level and defined as concordant if ICPC-2 codes of patients and GPs were identical. Concordance was classified into full, moderate or low, depending on the ranking of patients' CCs on GPs' list. As secondary outcome, we compared patients' CCs to GPs' diagnosis. Statistics included descriptive measures and a multivariate regression analysis of factors that are modifying concordance. The mean age of patients was 76.9 (SD 8.1) years, where 38% were male, taking 7.9 (SD 2.6) drugs on the long term. The most frequent complaint was pain. Concordance of the CC was given in 101/128 (78.9%) on the ICPC-2 chapter level, whereby 86/128 (67.2%) showed full, 8/128 (6.3%) moderate and 7/128 (5.5%) low concordance; 27/128 (21.1%) were discordant. Concordance between CCs and diagnosis was 53.6%. Concordance increased with the intensity of the CC rated by patients (OR 1.48, CI 1.13-1.94, P<0.001). The younger age and higher intake of drugs were significantly associated with an increased concordance between CCs and diagnosis. A majority of GPs perceive the CCs of the multimorbid patients correctly, but there is room for improvement. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 17% |
| Student > Bachelor | 8 | 17% |
| Student > Master | 6 | 13% |
| Student > Doctoral Student | 4 | 9% |
| Other | 4 | 9% |
| Other | 6 | 13% |
| Unknown | 11 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 21% |
| Psychology | 7 | 15% |
| Nursing and Health Professions | 5 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 9% |
| Social Sciences | 2 | 4% |
| Other | 3 | 6% |
| Unknown | 16 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 September 2017.
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#20,663,600
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Outputs from Patient preference and adherence
#1,432
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#253,299
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Outputs of similar age from Patient preference and adherence
#43
of 47 outputs
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