, Volume 20, Issue 10, pp 935-937

Brief report: Patient-physician agreement as a predictor of outcomes

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OBJECTIVE: To determine whether a patient-physician agreement instrument predicts important health outcomes.

DESIGN: Three hundred eighty patients with back pain were enrolled in a comparison of rapid magnetic resonance imaging with standard x-rays. One month later, patients rated agreement with their physician in the following areas: diagnosis, diagnostic plan, and treatment plan. Outcomes included patient satisfaction with care at 1 and 12 months and functional and health status at 12 months.

SETTING: Urban academic and community primary care and specialty clinics.

MEASUREMENTS AND MAIN RESULTS: Higher agreement at 1 month (using a composite sum of scores on the 3 agreement questions) was correlated in univariate analysis with higher patient satisfaction at 1 month (R=.637, P<.001). In multivariate analysis, controlling for 1-month satisfaction and other potential confounders, higher agreement independently predicted better 12-month patient satisfaction (β=0.188, P=.003), mental health (β=1.080, P<.001), social function (β=1.124, P=.001), and vitality (β=1.190, P<.001).

CONCLUSION: Agreement between physicians and patients regarding diagnosis, diagnostic plan, and treatment plan is associated with higher patient satisfaction and better health status outcomes in patients with back pain. Additional research is required to clarify the relationship between physician communication skills, agreement, and patient outcomes.

The authors have no conflicts of interest to declare for this article or this research.
This paper was presented at the 26th Annual SGIM Meeting, Vancouver, British Columbia, May 2003.
This work was supported by Grants HS-09499 from the Agency for Healthcare Research and Quality, and P60-AR48093 from the National Institute for Arthritis and Musculoskeletal and Skin Diseases.