Rheumatology patients and physicians differ in ranking status outcomes

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – The health and symptom status outcomes valued most by patients with rheumatic diseases differ considerably from those judged most important by their physicians, researchers from the University Hospitals of Cleveland report.

Drs. C. Kent Kwoh and Said A. Ibrahim collected data on 79 rheumatology patients and four rheumatologists. Before seeing their physician, patients were asked to complete a questionnaire that asked about the importance of symptom status outcomes from treatment. Physicians were then asked to complete the same questionnaire identifying which factors were most important to their patient.

Thirty-eight percent of the patients rated activities involving the lower extremities as most important, while 27% rated activities involving the hands and wrists as most important and 23% rated activities related to daily living as most important, according to the report in the August issue of Arthritis Care and Research.

However, physicians rated activities involving the hands and wrists as being the most important to almost half of the patients and activities involving the lower extremities as being most important to almost one third of the patients. They also identified activities of daily living as most important to only 9% of the patients.

Forty-two percent of the patients rated the feeling of being in control as the most important mental health outcome. Twenty-two percent rated making decisions and problem solving as most important, 18% rated feelings of being happy as most important and 16% rated feelings of being satisfied as most important.

Physicians saw making decisions or feelings of being happy as the most important mental health outcomes for a third of the patients and the feeling of being in control as most important for only 21% of their patients, Drs. Kwon and Ibrahim found.

Physicians did better when they identified activities involving working at a job and at home as the most important social outcomes, with 62% of the physicians and 84% of the patients rating this as most important.

Because patients' preferences and value systems significantly affect their healthcare, physicians "need to ask patients about their treatment preferences in clinical encounters," the investigators conclude.

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