Association between discontinuity of care and patient trust in the usual rheumatologist among patients with systemic lupus erythematosus: a cross-sectional study

Arthritis Res Ther. 2024 Nov 11;26(1):195. doi: 10.1186/s13075-024-03428-0.

Abstract

Background: Patient trust plays a central role in the patient-physician relationship. This study aimed to determine whether the number of outpatient visits with a covering rheumatologist is associated with patient trust in their usual rheumatologist.

Methods: Japanese adults with systemic lupus erythematosus (SLE) who met the 1997 revised classification criteria of the American College of Rheumatology and had outpatient visits with a covering rheumatologist in the past year were included. We used the 11-item Japanese version of the modified Trust in Physician Scale (range 0-100) to assess patient trust. A general linear model with cluster-robust variance estimation was used to evaluate the association between the number of outpatient visits with covering rheumatologists and the patient's trust in their usual rheumatologist.

Results: Of the 515 enrolled participants, 421 patients with SLE were included in our analyses. Patients were divided into groups according to the number of outpatient visits with a covering rheumatologist in the past year as follows: no visits (59.9%; reference group), one to three visits (24.2%; low-frequency group), and four or more visits (15.9%; high-frequency group). The median Trust in Physician Scale score was 81.8 (interquartile range: 72.7-93.2). Both the low-frequency group (mean difference: -3.03; 95% confidence interval [CI] -5.93 to -0.80) and high-frequency group (mean difference: -4.17; 95% CI -7.77 to -0.58) exhibited lower trust in their usual rheumatologist.

Conclusion: This study revealed that the number of outpatient visits with a covering rheumatologist was associated with lower trust in a patient's usual rheumatologist.

Keywords: Discontinuity of care; Outpatient visits; Patient trust; Patient-physician relationship; Systemic lupus erythematosus.

MeSH terms

  • Adult
  • Continuity of Patient Care
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lupus Erythematosus, Systemic* / psychology
  • Lupus Erythematosus, Systemic* / therapy
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Rheumatologists* / psychology
  • Rheumatology / methods
  • Trust*