Development of a Rheumatology-specific Patient Concerns Inventory (PCI) and its use in the Rheumatology outpatient clinic setting

A E Ahmed, D Lowe, J A Kirton, M O'Brien, A Mediana, H Frankland, H Bruce, T Kennedy, S Rogers, R J Motts

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Abstract

Objectives Successful management of rheumatic conditions involves increasing complexity of care. Delivering this in a holistic way is a growing challenge. The aim of this study was to develop a Patient Concerns Inventory (PCI) and assess it in the Rheumatology clinic setting. Methods This observational exploratory study occurred with two phases. Phase 1: the PCI was developed after systematic literature search, expert opinion and three patient focus group discussions. Phase 2: the PCI was piloted in a general Rheumatology clinic. Results Fifty-four patients were assessed in the pre-PCI group and 51 in the post-PCI group. Median (IQR) duration of consultation was 8 (5-14) minutes without PCI and 15 (10-20) minutes with PCI. The pre-PCI group raised 335 concerns from 50 patients, median (IQR) of 5 (3-10) per patient, rising post-PCI to 521 concerns, median (IQR) of 9 (5-16) from 51 patients, p=0.002. Additional concerns predominantly arising from ‘Physical and functional well-being’ and ‘Social care and wellbeing’ domains. Most patients rated their experience with their doctor in the consultation as excellent or outstanding across all 11 questions in the questionnaire, both before and after the introduction of the PCI to the clinic setting. Conclusion The PCI is a useful holistic needs assessment tool for Rheumatology clinics. Although its use may initially prolong the consultation slightly, patients can raise a significantly higher number of concerns that do not occur at the expense of patient satisfaction. This may help in identifying areas of ‘unmet need’, which previously went unnoticed.
Original languageEnglish
Pages (from-to)779-787
JournalThe Journal of Rheumatology
Volume43
Issue number4
Early online date15 Feb 2016
DOIs
Publication statusE-pub ahead of print - 15 Feb 2016

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