Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 1997 Oct;12(10):597-606.

Effects of a self-administered previsit questionnaire to enhance awareness of patients' concerns in primary care.

Author information

1
Department of Health Research & Policy, Stanford University School of Medicine, CA 94305-90521, USA.

Abstract

OBJECTIVE:

To determine if a self-administered previsit questionnaire designed to increase awareness of patients' concerns alters the visit duration, content of the discussion, and patient and physician satisfaction.

DESIGN:

A balanced, two-arm trial in which physicians were randomized.

SETTING:

Two primary-care clinics affiliated with a university hospital.

PATIENTS/PARTICIPANTS:

Ten physicians and 201 continuity-care patients.

INTERVENTIONS:

In intervention visits, patients completed a previsit questionnaire asking about the desire for medical information, psychosocial assistance, therapeutic listening, general health advice, and biomedical treatment. Physicians reviewed questionnaires with patients during the visit.

MEASUREMENTS AND MAIN RESULTS:

We used audiotapes of encounters to quantify the duration of the encounter and measured the number and type of diagnoses discussed in the visit, and patient and physician satisfaction with the encounter. Intervention visits were 34% longer (increase of 6.8 minutes; 95% confidence interval [CI] 0.4, 13.2) than control visits with most of the additional time spent in discussion of biomedical diagnoses (3.35 minutes; 95% CI 0.00, 6.72) and in the performance of the physical examination (2.7 minutes; 95% CI 0.5, 4.9). The number of diagnoses discussed per visit was 30% higher in intervention visits (increase of 1.7 diagnoses per visit; 95% CI 0.3, 3.2), but patients' satisfaction with these visits tended to be lower.

CONCLUSIONS:

Using a previsit questionnaire to increase awareness of the patients' concerns may entail a trade-off between conflicting goals: trying to respond to patient concerns while not significantly increasing the cost per visit. A future challenge is to develop and refine techniques with sufficient efficacy to justify the expense of implementing the intervention and the longer visit needed to respond adequately to patients' concerns.

PMID:
9346455
PMCID:
PMC1497170
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Support Center