You have full text access to this OnlineOpen article

BRIEF REPORT: Patient-Physician Agreement as a Predictor of Outcomes in Patients with Back Pain

  1. Thomas O. Staiger MD1,
  2. Jeffrey G. Jarvik MD, MPH2,3,4,
  3. Richard A. Deyo MD, MPH1,2,4,
  4. Brook Martin BS, MPH4,
  5. Clarence H. Braddock III MD, MPH5

Article first published online: 14 JUL 2005

DOI: 10.1111/j.1525-1497.2005.0175.x

Issue

Journal of General Internal Medicine

Journal of General Internal Medicine

Volume 20, Issue 10, pages 935–937, October 2005

Additional Information

How to Cite

Staiger, T. O., Jarvik, J. G., Deyo, R. A., Martin, B. and Braddock, C. H. (2005), BRIEF REPORT: Patient-Physician Agreement as a Predictor of Outcomes in Patients with Back Pain. Journal of General Internal Medicine, 20: 935–937. doi: 10.1111/j.1525-1497.2005.0175.x

Author Information

  1. 1

    Department of Medicine, University of Washington, Seattle, Wash, USA

  2. 2

    Department of Health Services, University of Washington, Seattle, Wash, USA

  3. 3

    Departments of Radiology and Neurosurgery, University of Washington, Seattle, Wash, USA

  4. 4

    Center for Cost and Outcomes Research, Stanford University, Stanford, Calif, USA

  5. 5

    Department of Medicine and Center for Biomedical Ethics, Stanford University, Stanford, Calif, USA

*Address correspondence and requests for reprint to Dr. Staiger: 4245 Roosevelt Way NE, Seattle, WA, 98105 (e-mail: staiger@u.washington.edu).

Publication History

  1. Issue published online: 14 JUL 2005
  2. Article first published online: 14 JUL 2005
  3. Received for publication March 7, 2005 and in revised form April 14, 2005 Accepted for publication April 19, 2005

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (73K)

Keywords:

  • physician-patient communication;
  • agreement;
  • back pain;
  • satisfaction

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.

View Full Article (HTML) Get PDF (73K)