It Is Time to Ask Patients What Outcomes Are Important to Them
Date of this version
Objectives: To identify the outcomes desired by patients (and their family members) with abdominal or back pain and to compare patient and physician opinions regarding the importance of each outcome. Study Design: Mixed methods. Methods: After identifying 21 potentially important outcomes from the literature and telephone interviews with patients and family members, we asked 40 patients, 11 family members, and 11 primary care physicians in telephone interviews to rate the importance of each outcome to patients on a scale of 1 to 5 scale (5 = most important), stratified by pain location. Results: Mean patient ratings of the 21 outcomes ranged from 3.3 to 5, with the average rating across all items higher for patients with back pain than those with abdominal pain (4.50 vs 4.09; P = .049). Physicians rated the importance of these outcomes to patients significantly lower than the patients did for both abdominal pain (4.1 vs 3.5; P = .04) and back pain (4.5 vs 3.6; P = .0003). Family member ratings were similar to those of the patients (4.3 vs 4.2; P = .8), whereas physicians rated the importance to patients to be an average of 0.6 points lower than the ratings of patients for abdominal pain and 0.8 points lower for back pain. Conclusions: Many outcomes are important to patients and their family members, but they mostly represent quality-of-life events rather than the symptom and function measures heretofore focused on by researchers. Physicians appear to rate most of these outcomes somewhat lower in importance.
American Journal of Accountable Care