The impact of psychosomatic co-morbidity on discordance with respect to reasons for encounter in general practice.

Schneider, A; Wartner, E; Schumann, I; Horlein, E; Henningsen, P; Linde, K

doi:10.1016/j.jpsychores.2012.09.007

2013

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Dokumenttyp:: Journal Article; Article
Autor(en):: Schneider, A; Wartner, E; Schumann, I; Horlein, E; Henningsen, P; Linde, K
Titel:: The impact of psychosomatic co-morbidity on discordance with respect to reasons for encounter in general practice.
Abstract:: Concordance between general practitioners (GPs) and patients is an essential requirement for treatment success and patient satisfaction in general practice. The objectives of this were to estimate the total amount of discordance with respect to reason for encounter (RFE) during consultation in German general practices, and to explore the influence of psychosomatic co-morbidity of the patients in case of discordance.1101 consecutive patients completed a questionnaire, including questions about the RFE and the Patient Health Questionnaire (PHQ). RFEs, as stated by the patients and diagnosed by the GPs were matched according to a predefined index. Factors that may influence the level of discordance between patients' RFE and GPs' RFE were analysed.Amount of concordance was 74.9%, incomplete concordance 11.2%, discordance in different physical RFEs was 9.1%, and discordance when GPs diagnosed psychosomatic illness while patients presented physical complaints was found in 2.5%. The number of RFE (OR 3.03; 95%CI 2.48-3.69; P<.001), depression (OR 2.27; 95%CI 1.51-3.41), anxiety (OR 1.78; 95%CI 1.03-3.10) and somatisation syndrome (OR 2.20; 95%CI 1.50-3.22) significantly predicted incomplete concordance and discordance, respectively. The number of RFE was significantly associated with depression (OR 1.32; 95%CI 1.09-1.61) and somatoform syndrome (OR 1.45; 95%CI 1.21-1.74).The considerable amount of discordance and incomplete concordance can partly be explained by the psychosomatic co-morbidity of the patients. If it is seen as a fundamental right of patients to be adequately understood, more efforts are necessary to improve patient centredness. Further studies have to evaluate if improvement of identification of psychosomatic co-morbidity might reduce discordance.
Zeitschriftentitel:: J Psychosom Res
Jahr:: 2013
Band / Volume:: 74
Heft / Issue:: 1
Seitenangaben Beitrag:: 82-5
Sprache:: eng
Volltext / DOI:: doi:10.1016/j.jpsychores.2012.09.007
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/23272993
Print-ISSN:: 0022-3999
TUM Einrichtung:: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie; Lehrstuhl für Allgemeinmedizin (Prof. Schneider) (keine SAP-Zuordnung!)
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