Patient Satisfaction Increased When Advance Directives Discussed
WESTPORT (Reuters Health) - Elderly patients with chronic illnesses appear to be more satisfied with their primary care physicians and outpatient visits when advance directives are discussed, according to a report published in the January issue of the Journal of General Internal Medicine.
Patient Satisfaction Increased When Advance Directives Discussed January 12, 2001 WESTPORT (Reuters Health) - Elderly patients with chronic illnesses appear to be more satisfied with their primary care physicians and outpatient visits when advance directives are discussed, according to a report published in the January issue of the Journal of General Internal Medicine.
Dr. William M. Tierney, from the Roudebush VA Medical Center, in Indianapolis, and colleagues assessed the impact that advance directive discussions had on satisfaction with care in 686 patients who were at least 75 years old or at least 50 years old with serious underlying disease.
After controlling for baseline satisfaction and physician, patient, and visit factors, the authors found that patients reported greater satisfaction with their physician when advance directives were discussed.
In addition, patient satisfaction with a primary care visit improved significantly when physicians had previously discussed advance directives. "This effect on satisfaction with the visit was greater for prior discussions than with discussions held on the day that satisfaction was assessed," the researchers point out.
This finding suggests "that the discussion initiates thinking about advance directives by the patient that, over time, increases appreciation of the physician and the primary care he or she delivers," Dr. Tierney's team explains.
While 34% of patients rated visits prior to a discussion as excellent, more than half of the subjects reported an excellent visit after advance directives were discussed, the authors state.
"Discussions of advance directives are appropriate for primary care patients in general and especially for the elderly and chronically ill patients in this study," the researchers conclude.
Dr. Tierney's team urges "primary care practices to encourage their physicians to initiate discussions about advance directives, especially with patients at risk for morbid events." The investigators point out that "these efforts seem to enhance the doctor-patient relationship, and the effects are both substantial and lasting."
J Gen Intern Med 2001;16:32-39.
