A recent study involving patients with sarcoma identified patient-physician disagreement regarding patients’ level of function and pain to be common. However, outcomes at 12 months tended to be better where there were higher levels of patient-physician agreement at baseline. Results of the study were published in the Journal of Cancer Survivorship.
“Taken together the findings suggest that patient-physician agreement, which may be a proxy of communication, play a role in the patient pathways,” the study investigators wrote.
The study was a secondary analysis of longitudinal data from a specialty clinic for patients with sarcoma in Montreal, Canada. The investigators performed descriptive statistical analyses of patient demographics and clinical characteristics, in addition to patient-physician agreement.
Patients completed the European Quality of Life Questionnaire (EQ-5D) for self-reporting of health-related quality of life, in addition to other questionnaires. Physicians completed the Musculoskeletal Tumour Society Score (MSTS), which assesses functional condition and other domains, such as pain and functioning. Patient-physician agreement was evaluated based on scores on questionnaires.
The study included 806 patients (mean age, 53.29 years [SD, 18.99]). Among these patients, 648 had baseline scores available from both self-reported and physician-reported levels of function.
Disagreement on function was observed at baseline between patient and physician assessments for 43.4% of patients. Disagreement involved physicians rating patient function as worse than patients did in 57.3% of cases of disagreement. In 42.7% of cases of disagreement, patients rated their function as worse than physicians did.
Patient-physician agreement on the level of function at baseline was associated with significantly better daily function, compared with a lack of agreement. Patients for whom agreement with the physician improved over time also showed significantly better daily function at 12 months than did patients for whom agreement did not improve. Associations between patient-physician agreement on function and outcomes of quality of life and fatigue were also observed.
Regarding pain, 45.7% of patients had disagreement with physicians on baseline scores. In 54.7% of these cases of disagreement, physicians rated patients’ pain as worse than patients did, while in 45.3% of cases the patients rated their pain as worse than physicians did. With greater patient-physician agreement on pain at baseline, patient quality of life was also significantly better than it was for patients who rated their pain as worse than their physicians did.
“Although most patients generally improve in terms of daily functioning, quality of life and fatigue over time, patient-physician agreement from baseline contributed to better scores,” the study investigators wrote in their report.
Reference
Košir U, van de Wal D, Husson O, Zablith N, Turcotte RE. Patient-physician agreement on function and pain is associated with long-term outcomes in sarcoma: findings from a longitudinal study. J Cancer Surviv. Published online October 17, 2023. doi:10.1007/s11764-023-01473-3