Patient-Physician Agreement in Reporting and Prioritizing Existing Chronic Conditions

Abstract

Purpose: In this study, we aimed to assess (1) the agreement between patient self-reports and general practitioner (GP) reports of the chronic conditions affecting the patients and (2) the agreement between patients and GPs on health priorities in a primary care setting.

Method: Patients were recruited in the Parisian area of France by a convenience sample of GPs; eligibility criteria required that the GP was the patient's listed primary care provider for at least 12 months. Participants were asked to report all the patient's current chronic conditions by using a previously developed list of 124 chronic conditions and write a list of up to 3 priority conditions.

Results: From April to May 2017, 233 patients were recruited from 16 GP practices. Agreement between the number of conditions reported by patients and by GPs was moderate (intraclass correlation coefficient 0.59, 95% CI, 0.50 to 0.69). Agreement between patient self-reports and GP reports of each chronic condition ranged from very good (eg, κ = 0.85 for hypothyroidism) to poor (eg, κ = 0.12 for chronic anxiety disorder). Among the 153 patient-GP pairs for which both the patient and GP wrote a priority list, 45 (29.4%) of patients' first priorities did not appear anywhere on the corresponding GPs' lists, and 19 (12.4%) pairs had no matching priority condition.

Conclusions: Agreement between patients and their GPs varied widely depending on the diseases reported. Low agreement on health priorities suggests a need for improvement to ensure better alignment between patient and physician perspectives.

Keywords: chronic diseases; patient-centered care; shared decision making.

Figure 1

Agreement between patients and general practitioners (GPs) on health priorities (n = 153 patient-GP pairs). COPD = chronic obstructive pulmonary disease; GERD = gastroesophageal reflux disease. Each bar corresponds to a chronic condition. The width of a bar is proportional to the number of patient-GP pairs for which the chronic condition was present in at least 1 priority list (for a given patient-GP pair, a given condition could have been reported in the patient list, the GP list, or both lists). For clarity, we plot here only the 10 most frequently reported conditions. All results are detailed in Supplemental Table 4 (http://www.AnnFamMed.org/content/17/5/396/suppl/DC1).