title: Predicting reports of unmet expectations among rheumatology patients.
abstract: OBJECTIVE
  Approximately 25% of patients report unmet expectations after their doctor visits. In a longitudinal study of rheumatology patients, we examined whether changes in health status could predict unmet expectations.
  
  
  METHODS
  Arthritis patients (n = 177) responded to 2 surveys (baseline and 6-month followup). Both surveys contained questions on health status (functional status, pain, helplessness, psychological status) and visit duration. The followup survey contained questions on postvisit unmet expectations. Factors associated with unmet expectations were determined.
  
  
  RESULTS
  Fifty-eight patients (33%) reported unmet expectations, most often for information (47%) and new medications (31%). Unmet expectations were more common among patients with greater baseline helplessness (odds ratio [OR] 1.9, 95% confidence interval [95% CI] 1.0-3.6) and short doctor visits at followup (OR 5.6, 95% CI 2.4-13.1). Unmet expectations were less common among those experiencing a decline in pain (OR 0.3, 95% CI 0.1-0.9).
  
  
  CONCLUSIONS
  Attention to the patient's level of pain and helplessness and duration of the visit may limit reports of unmet expectations.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and Emory University, Atlanta, Georgia, USA. jrao@cdc.gov
authors.forename: Jaya K
authors.initials: JK
authors.lastname: Rao
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Anderson
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000628:therapy*; D001294:Attitude to Health; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006380:Helplessness, Learned; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012219:Rheumatology / Q000592:standards / Q000706:statistics & numerical data*