Patients expectations and fulfilment of expectations before and after treatment for suspected coronary artery disease assessed with a newly developed questionnaire in combination with established health-related quality of life questionnaires

• ABSTRACT Background Clinical decision-making is often based on evidence of outcome after a specific treatment. Healthcare providers and patients may, however, have different perceptions and expectations of what to achieve from a certain healthcare measure. Aims To evaluate patients’ expectations, perceptions and health related quality of life (HRQoL) before a care process including coronary angiography for suspected coronary artery disease and to evaluate the fulfilment of these expectations in relation to established patient reported outcome measures (PROMs) 6 months later. Furthermore, an aim was to try to define meaningful patient reported experience measures (PREMs) in this population. Methods 544 patients planned for coronary angiography completed a newly developed questionnaire to assess expectations and perceptions of treatment, the expectation questionnaire (ExpQ) and two established HRQoL questionnaires together with the established generic Short-Form 36 (SF36) and the disease specific Seattle Angina Questionnaire (SAQ). Results Patients had before the intervention, in general, high expectations of improvement after investigation and treatment and there was a positive attitude towards life style changes, medication and participation in decision-making regarding their own treatment. Only, 56.4% of the patients, however, reported fulfilment of treatment expectations. Fulfilment of treatment expectations correlated strongly with improvement in HRQoL after the care process. Conclusions To measure patients’ expectations and fulfilments of these may offer simple and meaningful outcomes to evaluate a healthcare process from a patient’s perspective. To approach patients’ expectations may also strengthen patient involvement in the care process with the possibilities of both higher patient satisfaction and medical results of the treatment.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

What is already known about this subject? Most studies report endpoints such as death

myocardial infarction and hospitalisations. However

less is known about patients ́ expectations and fulfilment of these after an intervention. What does this study add? Validated methods to measure health related quality of life (HRQoL) already exists

but there are no established instruments to explore the patients’ expectations and fulfilment of these after an interventional procedure. This study reports both patient reported outcome and experience measures (patient reported outcome measure (PROMs) and patient reported experience measures (PREMs)) within the same questionnaire (the expectation questionnaire

ExpQ). The ExpQ is found to correlate with known validated HRQoL instruments. How might this impact on clinical practice? Fulfilments of expectations are associated with improvement in quality of life. To measure PROMs and PREMs may be a simple and meaningful measure to evaluate and improve a healthcare process from the patient’s perspective.

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