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Predicting reports of unmet expectations among rheumatology patients.

Rao JK, Weinberger M, Anderson LA, Kroenke K. Predicting reports of unmet expectations among rheumatology patients. Arthritis Rheum. 2004 Apr 15; 51(2):215-21.

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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). CONCLUSION: Attention to the patient's level of pain and helplessness and duration of the visit may limit reports of unmet expectations.

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