Why are you here again? Concordance between consumers and providers about the primary concern in recurring psychiatric visits

Psychiatry Res. 2014 Dec 15;220(1-2):541-8. doi: 10.1016/j.psychres.2014.07.049. Epub 2014 Jul 31.

Abstract

Patient-centered care has become increasingly important over the last decade, both in physical and mental health care. In support of patient-centered care, providers need to understand consumers׳ primary concerns during treatment visits. The current study explored what primary concerns were brought to recurring psychiatric visits for a sample of adults with severe mental illness (N=164), whether these concerns were concordant with those recognized by providers, and which factors predicted concordance. We identified 17 types of primary concerns, most commonly medications and symptoms, with only 50% of visits showing evidence of at least partial agreement between consumers and providers. Contrary to expectations, consumer demographics, activation, trust, and perceptions of patient-centeredness were not predictive, while greater preferences for autonomy predicted poorer agreement. Our findings highlight the need for interventions to promote a shared understanding of primary concerns in recurring psychiatric visits. Further attention is needed to ensure the provision of patient-centered care such that consumer concerns are acknowledged and addressed within recurring psychiatric visits.

Keywords: Communication; Patient-centered care; Severe mental illness; Shared decision-making.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • Health Services Needs and Demand*
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Mental Health Services*
  • Middle Aged
  • Patient Participation*
  • Patient-Centered Care*
  • Recurrence