Do doctors and patients agree on cardiovascular-risk management recommendations post-consultation? The INTERMEDE study

Schieber, Anne-Cécile; Kelly-Irving, Michelle; Rolland, Christine; Afrité, Anissa; Cases, Chantal; Dourgnon, Paul; Pascal, Jean; Lang, Thierry

doi:10.3399/bjgp11x561159

Cited by 13 publications

(12 citation statements)

References 21 publications

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“…Across studies and chronic diseases, patients express a profound need for more information about their disease, treatment, and disease self-management [24,[36][37][38][39][40][41]. This has also been recognized by GPs that describe the patients' disease knowledge as incomplete [42] and further, that a discrepancy exists in disease perception by patients and GPs [43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Disease self-management in patients with moderate COPD: a thematic analysis

Molin

Langberg

Lange

et al. 2020

European Clinical Respiratory Journal

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Background Treatment of patients with moderate chronic obstructive pulmonary disease (COPD) is challenged by the low priority of the disease by patients and general practitioners (GPs) affecting the extent of self-management. The aim of this study was to explore (i) attitudes to COPD self-management in patients with moderate COPD, (ii) perceptions of GP commitment to pulmonary rehabilitation in patients with moderate COPD, and (iii) COPD knowledge in patients with moderate COPD. Methods The study had a qualitative design using semi-structured interviews to explore the views of 14 patients diagnosed with moderate COPD. We applied strategic sampling to obtain maximum variation and conducted a thematic analysis of the data. Results Our main findings were that the degree of COPD self-management was linked to the resources of the informants. Further, the patients experienced that GPs only availed themselves of selected parts of the recommendations for COPD treatment by focusing on medical treatment and smoking cessation rather than physical activity and diet. Many patients lacked knowledge regarding the tolerated level of physical activity and therefore avoided activity increasing their heart rate. Finally, many patients were reluctant to accept the diagnosis because the disease is known to be self-inflicted. Conclusion Our study suggests that patients with moderate COPD need more information, especially regarding the positive effects of physical activity. GPs might need to devote more time to the three main elements of COPD treatment, smoking cessation, medical treatment, and physical activity, to promote self-management and a healthier lifestyle in patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Disease self-management in patients with moderate COPD: a thematic analysis

Molin

Langberg

Lange

et al. 2020

European Clinical Respiratory Journal

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“…However, the ability of practices to achieve this by-product depends on the adequacy of relationships between practitioners and their patients; less-educated people may have difficulties in building long-term relationships with health care providers. In France, physicianpatient agreement on the content of their interactions regarding risk-factor management differs by patients' education level (79).…”

Section: Preventionmentioning

confidence: 99%

Clinical Care and Health Disparities

Starfield

Gérvas

Mangin

2012

Annu. Rev. Public Health

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Health disparities, also known as health inequities, are systematic and potentially remediable differences in one or more aspects of health across population groups defined socially, economically, demographically, or geographically (88). This topic has been the subject of research stretching back at least decades. Reports and studies have delved into how inequities develop in different societies and, with particular regard to health services, in access to and financing of health systems. In this review, we consider empirical studies from the United States and elsewhere, and we focus on how one aspect of health systems, clinical care, contributes to maintaining systematic differences in health across population groups characterized by social disadvantage. We consider inequities in clinical care and the policies that influence them. We develop a framework for considering the structural and behavioral components of clinical care and review the existing literature for evidence that is likely to be generalizable across health systems over time. Starting with the assumption that health services, as one aspect of social services, ought to enhance equity in health care, we conclude with a discussion of threats to that role and what might be done about them.

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“…Patients and GPs do not always agree on what constitutes good general practice and important consultation skills, and on the priorities to be given to different indicators of quality care. [7][8][9] As satisfaction may depend on expectations being met, 15 any discrepancies between patients and GPs regarding patients' expectations could, at least in part, explain why GPs are unable to accurately perceive their patients' satisfaction. Another explanation could be that doctors prefer to be modest in their estimation and more critical of their skills than patients, for fear of being disappointed.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, patients and GPs do not always agree on what constitutes good general practice and on the priorities to be given to different indicators of quality care. [7][8][9] Overall, doctors seem poor at accurately perceiving their patients' satisfaction level with general practice. [10][11][12][13][14] As patients' satisfaction seems to increase when their expectations are addressed by their GP, GPs are also advised to take into account patients' expectations.…”

Section: Introductionmentioning

confidence: 99%

How do GPs in Switzerland perceive their patients’ satisfaction and expectations? An observational study

2015

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ObjectivesTo assess doctors’ perceptions of their patients’ satisfaction and expectations in primary care.Study designCross-sectional study using questionnaires completed by general practitioners (GPs) and their patients.SettingPrimary care practices in Geneva, Switzerland.Participants23 GPs from a random list of 75 GPs practising in the canton of Geneva (participation rate 31%), who each recruited between 50 and 100 consecutive patients coming to the practice for a scheduled medical consultation, leading to a total of 1637 patients (participation rate: 97%, women: 63%, mean age: 54 years). Patient exclusion criteria were: new patients, those consulting in an emergency situation or suffering from disorders affecting their ability to consent, and those who did not speak French.Main outcome measuresPatients satisfaction with and expectations from the care they received in this practice; GPs perceptions of their patient's satisfaction and expectations.ResultsGPs underestimated all patient satisfaction items (p<0.001 for all items) whereas they overestimated their expectations, except for equipment (laboratory and X-ray) and some accessibility items. In a multivariate analysis to assess which GP factors were associated with correct assessment of their patients’ views, only GPs’ certification status was a significant factor.ConclusionsGPs tend to underestimate patients’ satisfaction but overestimate their expectations in primary care. These findings may help GPs to understand patients’ views in order to adequately meet their expectations and concerns.

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Do doctors and patients agree on cardiovascular-risk management recommendations post-consultation? The INTERMEDE study

Cited by 13 publications

References 21 publications

Disease self-management in patients with moderate COPD: a thematic analysis

Disease self-management in patients with moderate COPD: a thematic analysis

Clinical Care and Health Disparities

How do GPs in Switzerland perceive their patients’ satisfaction and expectations? An observational study

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