Infl uence of watch fulwaiting on sat is faction and anxiety among patients seeking care for unexplained complaints

Abstract

PURPOSE We undertook a study to determine whether test-ordering strategy and other consultation-related factors inf uence satisfaction with and anxiety after a consultation among patients seeking care for unexplained complaints. METHODS A cluster-randomized clinical trial was conducted in family medicine practices in the Netherlands. Participants were 498 patients with unexplained complaints seen by 63 primary care physicians. Physicians either immedi- ately ordered a blood test for patients or followed a 4-week watchful waiting approach. Physicians and patients completed questionnaires asking about their characteristics, satisfaction with care, and anxiety, and aspects of the consulta- tion. The main outcomes were patient satisfaction and anxiety. Data were ana- lyzed by multilevel logistic regression analysis. RESULTS Patients were generally satisf ed with their consultation and had moder- ately low anxiety afterward (mean scores on 11-point scales, 7.3 and 3.1, respec- tively), with no difference between the immediate testing and watchful waiting groups (?2 = 2.4 and 0.3, respectively). The factors associated with higher odds of satisfaction were mainly related to physician-patient communication: patients' satisfaction with their physician generally, feeling taken seriously, and knowing the seriousness of complaints afterward; physicians' discussing testing and not considering complaints bearable; and older physician age. The same was true for factors associated with higher odds of anxiety: patients expecting testing or referral, patients not knowing the seriousness of their complaints afterward, and physicians not seeing a cause for alarm. CONCLUSIONS Test-ordering strategy does not inf uence patients' satisfaction with and anxiety after a consultation. Instead, specif c aspects of physician- patient communication are important. Apparently, primary care physicians underestimate how much they can contribute to the well-being of their patients by discussing their worries.