Article Figures & Data
Figures
- Figure 1
Agreement between patients and general practitioners (GPs) on health priorities (n = 153 patient-GP pairs).
COPD = chronic obstructive pulmonary disease; GERD = gastroesophageal reflux disease.
Each bar corresponds to a chronic condition. The width of a bar is proportional to the number of patient-GP pairs for which the chronic condition was present in at least 1 priority list (for a given patient-GP pair, a given condition could have been reported in the patient list, the GP list, or both lists). For clarity, we plot here only the 10 most frequently reported conditions. All results are detailed in Supplemental Table 4 (http://www.AnnFamMed.org/content/17/5/396/suppl/DC1).
Tables
Characteristics Value Age, median (IQR), y 59 (41.0-72.0) Female sex, n (%) 139 (59.7) Marital status,a n (%) Single, never married 50 (21.5) Married or domestic partnership 137 (58.8) Divorced or separated 25 (10.7) Widowed 15 (6.4) Level of education,b n (%) Primary school 10 (4.3) Secondary school 50 (21.5) High school graduate 29 (12.4) Bachelor’s degree 46 (19.7) Master’s degree or other advanced degree beyond a master’s degree 84 (36.1) Other 7 (3.0) Patients with ALD status,c n (%) 87 (37.3) IQR = interquartile range.
↵a 6 missing data.
↵b 7 missing data.
↵c ALD status is a French medico-administrative program that refers to a list of recognized chronic illnesses (affections de longue durée [ALDs]). Patients with ALD status are covered at 100% by the French Social Security for expenditures related to their disease.
- Table 2
Agreement Between Patient Self-Reports and General Practitioner (GP) Reports of Patients’ Chronic Conditions (n = 233 Patient-GP Pairs)
Chronic conditiona Patient Report n (%) 95% CI GP Report N (%) 95% CI Patient-GP Agreementb Agreement Statistic κ (95% CI) Patient–, GP– Patient+, GP– Patient–, GP+ Patient+, GP+ High blood pressure 80 (34.3) [28.2-40.4] 90 (38.6) [32.4-44.9] 134 9 19 71 0.74 (0.64-0.85) Osteoarthritis 59 (25.3) [19.7-30.9] 42 (18.0) [13.1-22.9] 157 34 17 25 0.36 (0.25-0.46) Chronic anxiety disorder 33 (14.2) [9.7-18.7] 32 (13.7) [9.2-18.1] 176 25 24 8 0.12 (0.00-0.30) Chronic sleeping disorder 33 (14.2) [9.7-18.7] 7 (3.0) [0.8-5.2] 197 29 3 4 0.16 (0.00-0.32) Chronic low-back pain 32 (13.7) [9.2-18.1] 29 (12.4) [8.2-16.7] 183 21 18 11 0.26 (0.03-0.42) Gastroesophageal reflux disease or chronic gastritis 31 (13.3) [8.9-17.7] 32 (13.7) [9.2-18.1] 186 15 16 16 0.43 (0.29-0.53) Hearing impairment or presbycusis 27 (11.6) [7.5-15.7] 7 (3.0) [0.8-5.2] 205 21 1 6 0.32 (0.03-0.56) Chronic rhinitis or sinusitis 25 (10.7) [6.7-14.7] 17 (7.3) [4.0-10.6] 200 16 8 9 0.37 (0.23-0.51) Asthma 24 (10.3) [6.4-14.2] 18 (7.8) [4.5-11.2] 203 12 6 12 0.53 (0.35-0.71) Tobacco use 22 (9.4) [5.7-13.1] 25 (10.7) [6.7-14.7] 201 7 10 15 0.60 (0.46-0.74) ↵a For clarity, we report only the results for the 10 most prevalent chronic conditions (according to patient self-reports). The results for all chronic conditions are in Supplemental Table 4 (http://www.AnnFamMed.org/content/17/5/396/suppl/DC1).
↵b Symbols indicate whether the GP or patient reported (+) or did not report (–) the condition.
Supplemental Appendixes
Supplemental appendixes
Files in this Data Supplement:
- Supplemental data: Appendixes - PDF file
The Article in Brief
Patient-Physician Agreement in Reporting and Prioritizing Existing Chronic Conditions
Stephanie Sidorkiewicz , and colleagues
Background Multimorbidity is becoming the norm rather than the exception. Adults with multiple chronic conditions face challenges in navigating complex health care pathways. Their primary care physicians have responsibility for care coordination and prioritization. This study analyzed the level of agreement between patients and their primary care physicians in the identification and prioritizing of the patient's most pressing chronic conditions.
What This Study Found A cross-sectional observational study in France used self-reported questionnaires among 233 patient-physician pairs to identify the patient's chronic conditions from a list of 124 items and to rank the three most important conditions. Of the 153 pairs that generated priority lists, 29% of patients' first priorities did not appear anywhere on their corresponding physician's list, and 12% of pairs had no matching priority conditions. Furthermore, physicians failed to identify what condition mattered most to patients in 29% of cases. Agreement between patients and physicians varied by condition and were stronger for conditions like hypothyroidism, diabetes, and high blood pressure, and poorer for anxiety and sleep issues.
Implications
- The study was exploratory in nature, yet it points to a need for improved doctor-patient communication in the management of multiple chronic conditions.
