Purpose. Measures of patient satisfaction or dissatisfaction with treatment are increasingly being used as indicators of quality of care. As these measures become more widely used, it is important to know if patient dissatisfaction is associated with important processes or outcomes of medical care.
Patient Population and Methods. Survey of patient-reported asthma management issues using the Asthma Therapy Assessment Questionnaire in a Kaiser health maintenance organization in the Pacific Northwest. Associations between patient dissatisfaction with asthma treatment and patient-reported measures of asthma control, patient-provider communication, and belief in asthma medications (self-efficacy) were examined.
Results. Of the 5181 adult members with asthma enrolled in the health maintenance organization, 30% indicated dissatisfaction with current treatment. Dissatisfaction was higher among patients with a higher number of asthma control problems, patient-provider communication problems, or belief in medication problems (eg, failure to believe their medications are useful and inability to take asthma medications as directed). The odds of dissatisfaction with treatment were 2.8 (95% confidence interval [CI]: 2.4–3.3; P < .001) for asthma control problems, 2.0 (95% CI: 1.6–2.6; P < .001) for communication problems, and 8.0 (95% CI: 6.7–9.5; P < .001) for belief in medication problems compared with patients without these perceived problems.
Conclusion. Patient dissatisfaction with treatment may be related to important asthma disease management issues.
Reviewer’s Comments. The study did not distinguish those patients treated by specialists or primary care physicians. Nonetheless, the results also suggest that patients with more severe asthma are least satisfied with their care. However, most patients did not have basic treatment information, overused rescue medications, had regular nocturnal symptoms, and limitations in their activities. Sounds like they weren’t being well-managed.
- Copyright © 2002 by the American Academy of Pediatrics