30 research outputs found
Multimorbidity: can general practitioners identify the health conditions most important to their patients? Results from a national cross-sectional study in Switzerland
Faced with patients suffering from more than one chronic condition, or multimorbidity, general practitioners (GPs) must establish diagnostic and treatment priorities. Patients also set their own priorities to handle the everyday burdens associated with their multimorbidity and these may be different from the priorities established by their GP. A shared patient-GP agenda, driven by knowledge of each other's priorities, would seem central to managing patients with multimorbidity. We evaluated GPs' ability to identify the health condition most important to their patients.
Data on 888 patients were collected as part of a cross-sectional Swiss study on multimorbidity in family medicine. For the main analyses on patients-GP agreement, data from 572 of these patients could be included. GPs were asked to identify the two conditions which their patient considered most important, and we tested whether either of them agreed with the condition mentioned as most important by the patient. In the main analysis, we studied the agreement rate between GPs and patients by grouping items medically-related into 46 groups of conditions. Socio-demographic and clinical variables were fitted into univariate and multivariate models.
In 54.9% of cases, GPs were able to identify the health condition most important to the patient. In the multivariate model, the only variable significantly associated with patient-GP agreement was the number of chronic conditions: the higher the number of conditions, the less likely the agreement.
GPs were able to correctly identify the health condition most important to their patients in half of the cases. It therefore seems important that GPs learn how to better adapt treatment targets and priorities by taking patients' perspectives into account
Additional file 1: of Development of a monitoring instrument to assess the performance of the Swiss primary care system
Composition of the SPAM expert Panel group. (DOCX 12 kb
Additional file 2: of A prospective study assessing agreement and reliability of a geriatric evaluation
Two and three-way Intraclass Correlation Coefficient and Observed Disagreement. Technical details about statistics used in the study. (DOCX 66 kb
Additional file 1: Table S1. of A prospective study assessing agreement and reliability of a geriatric evaluation
Domains Investigated and Tests Used to Assess the Geriatric Patient. Domains assessed during the geriatric consultation and corresponding instruments. (DOCX 26 kb
HIV risk factors among targeted-arm patients accepting or declining the offer of rapid HIV testing.
<p>HIV risk factors among targeted-arm patients accepting or declining the offer of rapid HIV testing.</p
Flowchart diagram demonstrating primary and final HIV testing rates with targeted testing and non-targeted screening following randomisation of 160 patients presenting to the emergency department.
<p>Abbreviations: FOPH, Federal Office of Public Health; USI, unprotected sexual intercourse.</p
Association between the number of Federal Office of Public Health (FOPH) HIV risk factors and HIV rapid test acceptance among patients assigned to the targeted arm.
<p>Association between the number of Federal Office of Public Health (FOPH) HIV risk factors and HIV rapid test acceptance among patients assigned to the targeted arm.</p
Demographic characteristics of participating patients by study arm.
<p>Abbreviations: ED, Emergency department; SD, Standard deviation.</p
Questionnaire responses from participants declining HIV testing.
<p>Questionnaire responses from participants declining HIV testing.</p
Additional file 1: of Performance of a brief geriatric evaluation compared to a comprehensive geriatric assessment for detection of geriatric syndromes in family medicine: a prospective diagnostic study
Cross-tabulation of brief assessment tool results, by result of comprehensive geriatric assessment. (PDF 29 kb