Provider Perspectives of Patient Experiences in Primary Care Imaging

Abstract

Background: Imaging tests are a widely used tool in primary care with many known benefits. Without an understanding of which outcomes matter the most to patients, clinicians are challenged to balance the benefits and harms of imaging tests. This study aimed to explore the perceived impacts imaging tests have on patients from the perspective of the primary care providers (PCPs) and determine PCPs' understanding of patient-centered outcomes (PCOs) from imaging tests.Methods: Recruitment of PCPs occurred at 4 family medicine clinics in Washington and Idaho. Primary care physicians, nurse practitioners, or physician assistants who order imaging tests were eligible to participate. Semistructured interviews explored providers' perceptions of patient experiences during the process of ordering, performing and following up on imaging tests. Classic content analysis generated themes and subthemes.Results: Sixteen PCPs, including 11 physicians, 3 physician assistants, and 2 nurse practitioners, completed interviews. Two themes were identified: 1) perceived PCOs, and 2) factors influencing the incorporation of PCOs into clinical management . Perceived outcomes included emotions related to the answer a test provides and costs to the patient such as monetary, physical, and added risk. Patient expectations, provider-patient communication, and inadequate knowledge all contributed as barriers to incorporating PCOs into clinical management. Discussion: PCPs recognize different outcomes of imaging tests that they consider important for patients. While providers are perceptive to patient outcomes there remains a challenge to how patient outcomes are used to improve care. Communication with patients and improving provider knowledge are needed to incorporate identified PCOs. (J Am Board Fam Med 2019;32:392-397.)

Qualitative study to explore radiologist and radiologic technologist perceptions of outcomes patients experience during imaging in the USA

“…13 Primary care providers were able to connect the outcome pathways a bit more and reported that the answers provided from imaging tests influenced emotional outcomes and that there is additional burden on the patient from added testing, monetary and physical risks. 18 This evidence of triangulation from the four perspectives strengthens support for the occurrence and potential importance of these outcomes among patients undergoing imaging testing. 13 18 Indeed, previous research has highlighted the importance of psychosocial/emotional outcomes (often described as stress, anxiety or reassurance), [22][23][24] as well as physical impacts of tests (including comfort/discomfort) 25 and the value of information to patients such as knowledge about the test, awareness of harms, value (or lack of value) of knowing test findings.…”