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Research ArticleOriginal Research

The Effect of Achieving Patient-Reported Outcome Measures on Satisfaction

Leif I. Solberg, Stephen E. Asche, John Butler, David Carrell, Christine K. Norton, Jeffrey G. Jarvik, Rebecca Smith-Bindman, Juliana O. Tillema, Robin R. Whitebird and Jeanette Y. Ziegenfuss
The Journal of the American Board of Family Medicine November 2015, 28 (6) 785-792; DOI: https://doi.org/10.3122/jabfm.2015.06.150079
Leif I. Solberg
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
MD
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Stephen E. Asche
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
MA
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John Butler
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
MD
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David Carrell
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
PhD
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Christine K. Norton
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
MA
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Jeffrey G. Jarvik
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
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Rebecca Smith-Bindman
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
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Juliana O. Tillema
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
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Robin R. Whitebird
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
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Jeanette Y. Ziegenfuss
From the HealthPartners Institute for Education and Research, Minneapolis MN (LIS, SEA, JOT, RRW, JYZ); the HealthPartners Medical Group, Minneapolis MN (JB); the Group Health Research Institute, Seattle WA (DC); the University of Washington, Seattle (JGJ); and the University of California, San Francisco (RS-B).
PhD
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  • Article
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Article Figures & Data

Tables

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    Table 1. Outcomes Considered Important by Patients with Back or Abdominal Pain, Ranked by Their Importance Ratings*
    OutcomeImportance
    1. To find the cause of the pain4.9
    2. To trust that the treatment plan is appropriate4.7
    3. To return to normal life functions4.7
    4. To understand what may happen to you because of the problem4.6
    5. To prevent this problem from occurring again4.6
    6. To prevent long-term loss of function4.6
    7. To return to work and productivity as soon as possible4.5
    8. To experience no complications or side effects4.3
    9. To be assured that no unexpected, unrelated problems develop4.2
    10. To get rapid and complete relief from pain and other symptoms4.2
    11. To avoid being hospitalized4.1
    12. To avoid surgery4.1
    13. To avoid placing a burden or stress on family members4.1
    14. To minimize or avoid the need for further tests and medical visits3.9
    15. To minimize radiation exposure in the course of my care3.9
    16. To avoid personal costs for care3.9
    17. To minimize or avoid use of medication3.8
    18. To return to leisure/sports activities as soon as possible3.8
    19. To minimize discomfort from the tests used to assess the pain3.7
    • ↵* Ratings were made on a scale from 1 to 5, where 1 is “not at all important” and 5 is “extremely important.”

    • View popup
    Table 2. Characteristics of Survey Completers
    Respondents with Abdominal Pain (n = 201)Respondents with Back Pain (n = 167)P Value
    Female sex132 (66)98 (59).17
    Age (years), mean (SD)54.6 (17)55.7 (16).54
    Race
        White175 (88)140 (86).56
        Hispanic or Latino10 (5)6 (4).53
    Relationship status
        Married, living with partner130 (65)115 (69).14
        Separated, divorced, widowed39 (20)38 (23)
        Never married30 (15)14 (8)
    Education
        High school or less52 (26)45 (27).70
        Some college or tech school70 (35)55 (33)
        College graduate52 (26)40 (24)
        Postgraduate degree24 (12)27 (16)
    Work status
        Employed, self-employed121 (60)88 (53).12
        Out of/unable to work11 (6)14 (8)
        Homemaker10 (5)6 (4)
        Student2 (1)1 (1)
        Retired56 (28)57 (34)
    • Data are n (%) unless otherwise indicated. Differences by study group (abdomen or back) were tested using the Pearson χ2 test, Fisher exact test, or independent samples t test. SD, standard deviation.

    • View popup
    Table 3. Frequency of Achieving Outcomes Important to Patients (Ranked by Importance Rating)
    OutcomePatients with Abdominal Pain (n = 201)Patients with Back Pain (n = 167)P Value
    Found the cause of the pain126/201 (63)131/167 (78).001
    Trusted that the treatment plan was appropriate158/183 (86)127/153 (83).40
    Returned to normal life function by 1 month73/115 (63)*38/145 (26)*†<.001
    Understood (somewhat or very much) what may happen to them because of the problem142/201 (71)132/167 (79).07
    Avoided pain recurrence101/115 (88)‡33/46 (72)‡.01
    Avoided long-term loss of function31/42 (74)§51/106 (48)†§.005
    Returned to work and productivity soon10/46 (22)†¶10/53 (19)†¶.72
    Experienced no complications or side effects related to the cause or treatment of pain176/192 (92)88/163 (54)<.001
    Avoided unexpected problems not related to pain172/192 (87)154/162 (95).01
    Got rapid (within 1 week) and complete relief50/196 (26)†8/165 (5)†<.001
    Avoid hospitalization180/201 (90)155/167 (93).28
    Avoided surgery167/200 (84)145/166 (87).30
    Avoided burden on family135/201 (67)81/167 (49)†.003
    Avoided further tests, visits, treatments121/196 (62)76/162 (47)†.005
    Avoided additional radiation exposure180/195 (92)156/164 (95).28
    Avoided personal costs of care118/201 (59)85/166 (51).15
    Minimized use of medications122/199 (61)66/167 (40)†<.001
    Returned to leisure/sports activities within a few weeks150/197 (76)49/166 (30)†<.001
    Minimized uncomfortable tests or treatment167/201 (83)102/167 (61)<.001
    • Data are n/N (%).

    • ↵* Limited to patients whose pain interfered with day-to-day functioning at the time of the scan.

    • ↵† <50% Of patients experienced the outcome.

    • ↵‡ Limited to patients whose pain went away completely after the pain episode.

    • ↵§ Limited to patients whose pain interfered with day-to-day functioning at the time of the scan and pain was still affecting functioning 1 month after the scan.

    • ↵¶ Limited to patients who were working outside the home before the pain episode and who missed work or were not fully productive because of pain.

    • View popup
    Table 4. Relationship between Achieving Outcomes and Satisfaction with Results of Care (Ranked by Importance of Outcome to Patients)
    OutcomePatients with Abdominal PainPatients with Back Pain
    Very Satisfied (%)P ValueVery Satisfied (%)P Value
    Found out the cause of the pain
        Yes75<.0147.02
        No4425
    Trusted that the treatment plan was appropriate
        Yes72<.0153<.01
        No248
    Returned to normal life function by 1 month
        Yes73.0566<.01
        No5536
    Understood what may happen
        Some or very much73<.0150<.01
        Not at all3911
    Avoided recurrence
        Yes77.2965.29
        No6485
    Avoided long-term loss of function
        Yes64.0461<.01
        No2715
    Returned to work and productivity soon
        Yes70.7240.91
        No6442
    Avoided complications/side effects
        Yes64.2649.10
        No5036
    Avoided unexpected problems
        Yes63.7444.14
        No6012
    Got rapid and complete relief
        Yes78<.0188.01
        No5740
    Avoided hospitalization
        Yes63.7340.07
        No6767
    Avoided surgery
        Yes60.1040.13
        No7657
    Avoided burden on family
        Yes70<.0144.52
        No5040
    Minimized medical tests and visits
        Yes69.0753.02
        No5635
    Avoided additional radiation
        Yes63.8043.32
        No6725
    Avoided personal costs of care
        Yes64.6742.97
        No6242
    Minimized use of medications
        Yes58.0639.59
        No7144
    Returned to leisure/sports soon
        Yes67.0947.42
        No5340
    Avoided uncomfortable tests
        Yes63.8541.80
        No6243
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The Journal of the American Board of Family     Medicine: 28 (6)
The Journal of the American Board of Family Medicine
Vol. 28, Issue 6
November-December 2015
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The Effect of Achieving Patient-Reported Outcome Measures on Satisfaction
Leif I. Solberg, Stephen E. Asche, John Butler, David Carrell, Christine K. Norton, Jeffrey G. Jarvik, Rebecca Smith-Bindman, Juliana O. Tillema, Robin R. Whitebird, Jeanette Y. Ziegenfuss
The Journal of the American Board of Family Medicine Nov 2015, 28 (6) 785-792; DOI: 10.3122/jabfm.2015.06.150079

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The Effect of Achieving Patient-Reported Outcome Measures on Satisfaction
Leif I. Solberg, Stephen E. Asche, John Butler, David Carrell, Christine K. Norton, Jeffrey G. Jarvik, Rebecca Smith-Bindman, Juliana O. Tillema, Robin R. Whitebird, Jeanette Y. Ziegenfuss
The Journal of the American Board of Family Medicine Nov 2015, 28 (6) 785-792; DOI: 10.3122/jabfm.2015.06.150079
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