Meeting Patients’ Expectations for Asthma, Allergy Testing Improves Satisfaction

doctor with patient
doctor with patient
When patients visiting an allergy/immunology outpatient clinic had expectations met regarding diagnosis and testing, they were more likely to be satisfied with their visit.

This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology, taking place in Orlando, Florida. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI/WAO 2018.

ORLANDO — Meeting patient expectations regarding testing during an allergy- or immunology-related medical visit was most strongly associated with high patient satisfaction, according to research presented at the 2018 Joint Congress of the American Academy of Allergy, Asthma & Immunology/World Allergy Organization, held March 2-5, in Orlando, Florida.

Jaclyn Bjelac, MD, from the Department of Allergy & Clinical Immunology at the Cleveland Clinic in Ohio and colleagues conducted a survey of 198 adult patients following visits to allergy/immunology outpatient clinics at various Cleveland Clinic locations to determine whether addressing patient expectations affected patient satisfaction.

The survey included questions regarding a first-time visit with an allergy/immunology provider (yes or no), age, gender, reason for visit, whether the physician asked about expectations regarding a diagnosis to explain symptoms, whether the physician asked about expectations regarding testing (eg, allergy skin testing, sending blood samples for evaluation, or breathing testing), whether the patient’s expectations were met regarding treatment, whether the physician asked about expectations regarding relief of symptoms/symptom control, whether the physician asked about expectations regarding follow-up, and level of satisfaction regarding the visit (1=very dissatisfied to 5=very satisfied).

The reason(s) for visit included asthma, cough, or other breathing problem; nasal or sinus symptoms; eye symptoms; skin problems; food reaction/food allergy; drug/medication problem; insect allergy/reaction; immune problem/concern for immunodeficiency; or other.

Approximately 75 patients listed nasal or sinus problems as the reason for the visit, followed by asthma (n≈65) and skin problems (n≈60). More patients were women (n=142) than were men (n=56), but there was a wide age range (between ≤30 to ≥61 years).

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Overall, addressing patients’ expectations regarding any of the visit components correlated significantly with higher satisfaction scores, even when adjusted for age and gender. In particular, meeting patients’ expectations in terms of testing had one of the strongest associations with high satisfaction scores, followed by making a diagnosis to explain symptoms. These patients were 16.8 and 15.6 more likely to have high overall satisfaction, respectively (95% CI, 7.9-35.7 and 95% CI, 6.8-35.5, respectively). There was no correlation between overall satisfaction and visit diagnosis, number of visit diagnoses, and age or gender.

Although these findings may have been limited by an unvalidated questionnaire and the failure of the questionnaire to address compounding factors related to patient satisfaction, Dr Bjelac highlighted the importance of improving communication between physicians and patients.

“As you get more and more sub-specialized, you will find fewer patients who understand exactly what is going to happen, even very intelligent patients,” Dr Bjelac noted. She added that the root of most communication failures between physicians and patients occurs when the physicians “forget” how much they know and do not share that knowledge with their patients.

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Bjelac J, Schroer BC. Addressing specific patient expectations in the allergy/immunology outpatient clinic is associated with increased patient satisfaction. Presented at: 2018 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress; March 2-5, 2018; Orlando, FL. Poster 849.