BRIEF REPORT: Patient-physician agreement as a predictor of outcomes in patients with back pain.
OBJECTIVE
To determine whether a patient-physician agreement instrument predicts important health outcomes.


METHODS
Three hundred eighty patients with back pain were enrolled in a comparison of rapid magnetic resonance imaging with standard x-rays. One month later, patients rated agreement with their physician in the following areas: diagnosis, diagnostic plan, and treatment plan. Outcomes included patient satisfaction with care at 1 and 12 months and functional and health status at 12 months.


METHODS
Urban academic and community primary care and specialty clinics.


RESULTS
Higher agreement at 1 month (using a composite sum of scores on the 3 agreement questions) was correlated in univariate analysis with higher patient satisfaction at 1 month (R=.637, P<.001). In multivariate analysis, controlling for 1-month satisfaction and other potential confounders, higher agreement independently predicted better 12-month patient satisfaction (beta=0.188, P=.003), mental health (beta=1.080, P<.001), social function (beta=1.124, P=.001), and vitality (beta=1.190, P<.001).


CONCLUSIONS
Agreement between physicians and patients regarding diagnosis, diagnostic plan, and treatment plan is associated with higher patient satisfaction and better health status outcomes in patients with back pain. Additional research is required to clarify the relationship between physician communication skills, agreement, and patient outcomes.
Staiger
Thomas O
TO
Department of Medicine, University of Washington, Seattle, Wash, USA. staiger@u.washington.edu
Jarvik
Jeffrey G
JG
Deyo
Richard A
RA
Martin
Brook
B
Braddock
Clarence H
CH
D001416:Back Pain / Q000628:therapy*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D016896:Treatment Outcome