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Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study

INTRODUCTION: Because patients with a “suspicion of Lyme borreliosis (LB)” may experience medical wandering and difficult care paths, often due to misinformation, multidisciplinary care centers were started all over Europe a few years ago. The aim of our study was to prospectively identify the facto...

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Autores principales: Raffetin, Alice, Chahour, Amal, Schemoul, Julien, Paoletti, Giulia, He, Zhuoruo, Baux, Elisabeth, Patrat-Delon, Solène, Nguala, Steve, Caraux-Paz, Pauline, Puppo, Costanza, Arias, Pauline, Madec, Yoann, Gallien, Sébastien, Rivière, Julie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243684/
https://www.ncbi.nlm.nih.gov/pubmed/37280565
http://dx.doi.org/10.1186/s12879-023-08352-3
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author Raffetin, Alice
Chahour, Amal
Schemoul, Julien
Paoletti, Giulia
He, Zhuoruo
Baux, Elisabeth
Patrat-Delon, Solène
Nguala, Steve
Caraux-Paz, Pauline
Puppo, Costanza
Arias, Pauline
Madec, Yoann
Gallien, Sébastien
Rivière, Julie
author_facet Raffetin, Alice
Chahour, Amal
Schemoul, Julien
Paoletti, Giulia
He, Zhuoruo
Baux, Elisabeth
Patrat-Delon, Solène
Nguala, Steve
Caraux-Paz, Pauline
Puppo, Costanza
Arias, Pauline
Madec, Yoann
Gallien, Sébastien
Rivière, Julie
author_sort Raffetin, Alice
collection PubMed
description INTRODUCTION: Because patients with a “suspicion of Lyme borreliosis (LB)” may experience medical wandering and difficult care paths, often due to misinformation, multidisciplinary care centers were started all over Europe a few years ago. The aim of our study was to prospectively identify the factors associated with the acceptance of diagnosis and management satisfaction of patients, and to assess the concordance of the medical health assessment between physicians and patients 12 months after their management at our multidisciplinary center. METHODS: We included all adults who were admitted to the Tick-Borne Diseases Reference Center of Paris and the Northern Region (TBD-RC) (2017–2020). A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains and 13 items rated between 0 (lowest) and 10 (highest grade): (1)Reception; (2)Care and quality of management; (3)Information/explanations given to the patients; (4)Current medical condition and acceptance of the final diagnosis; (5)Overall appreciation. Factors associated with diagnosis acceptance and management satisfaction at 12 months were identified using logistic regression models. The concordance of the health status as assessed by doctors and patients was calculated using a Cohen’s kappa test. RESULTS: Of the 569 patients who consulted, 349 (61.3%) answered the questionnaire. Overall appreciation had a median rating of 9 [8;10] and 280/349 (80.2%) accepted their diagnoses. Patients who were “very satisfied” with their care paths at TBD-RC (OR = 4.64;CI95%[1.52–14.16]) had higher odds of diagnosis acceptance. Well-delivered information was strongly associated with better satisfaction with the management (OR = 23.39;CI95%[3.52–155.54]). The concordance between patients and physicians to assess their health status 12 months after their management at TBD-RC was almost perfect in the groups of those with confirmed and possible LB (κ = 0.99), and moderate in the group with other diagnoses (κ = 0.43). CONCLUSION: Patients seemed to approve of this multidisciplinary care organization for suspected LB. It helped them to accept their final diagnoses and enabled a high level of satisfaction with the information given by the doctors, confirming the importance of shared medical decisions, which may help to reduce health misinformation. This type of structure may be useful for any disease with a complex and controversial diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08352-3.
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spelling pubmed-102436842023-06-07 Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study Raffetin, Alice Chahour, Amal Schemoul, Julien Paoletti, Giulia He, Zhuoruo Baux, Elisabeth Patrat-Delon, Solène Nguala, Steve Caraux-Paz, Pauline Puppo, Costanza Arias, Pauline Madec, Yoann Gallien, Sébastien Rivière, Julie BMC Infect Dis Research INTRODUCTION: Because patients with a “suspicion of Lyme borreliosis (LB)” may experience medical wandering and difficult care paths, often due to misinformation, multidisciplinary care centers were started all over Europe a few years ago. The aim of our study was to prospectively identify the factors associated with the acceptance of diagnosis and management satisfaction of patients, and to assess the concordance of the medical health assessment between physicians and patients 12 months after their management at our multidisciplinary center. METHODS: We included all adults who were admitted to the Tick-Borne Diseases Reference Center of Paris and the Northern Region (TBD-RC) (2017–2020). A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains and 13 items rated between 0 (lowest) and 10 (highest grade): (1)Reception; (2)Care and quality of management; (3)Information/explanations given to the patients; (4)Current medical condition and acceptance of the final diagnosis; (5)Overall appreciation. Factors associated with diagnosis acceptance and management satisfaction at 12 months were identified using logistic regression models. The concordance of the health status as assessed by doctors and patients was calculated using a Cohen’s kappa test. RESULTS: Of the 569 patients who consulted, 349 (61.3%) answered the questionnaire. Overall appreciation had a median rating of 9 [8;10] and 280/349 (80.2%) accepted their diagnoses. Patients who were “very satisfied” with their care paths at TBD-RC (OR = 4.64;CI95%[1.52–14.16]) had higher odds of diagnosis acceptance. Well-delivered information was strongly associated with better satisfaction with the management (OR = 23.39;CI95%[3.52–155.54]). The concordance between patients and physicians to assess their health status 12 months after their management at TBD-RC was almost perfect in the groups of those with confirmed and possible LB (κ = 0.99), and moderate in the group with other diagnoses (κ = 0.43). CONCLUSION: Patients seemed to approve of this multidisciplinary care organization for suspected LB. It helped them to accept their final diagnoses and enabled a high level of satisfaction with the information given by the doctors, confirming the importance of shared medical decisions, which may help to reduce health misinformation. This type of structure may be useful for any disease with a complex and controversial diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08352-3. BioMed Central 2023-06-06 /pmc/articles/PMC10243684/ /pubmed/37280565 http://dx.doi.org/10.1186/s12879-023-08352-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Raffetin, Alice
Chahour, Amal
Schemoul, Julien
Paoletti, Giulia
He, Zhuoruo
Baux, Elisabeth
Patrat-Delon, Solène
Nguala, Steve
Caraux-Paz, Pauline
Puppo, Costanza
Arias, Pauline
Madec, Yoann
Gallien, Sébastien
Rivière, Julie
Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title_full Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title_fullStr Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title_full_unstemmed Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title_short Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
title_sort acceptance of diagnosis and management satisfaction of patients with “suspected lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243684/
https://www.ncbi.nlm.nih.gov/pubmed/37280565
http://dx.doi.org/10.1186/s12879-023-08352-3
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