Patients May Be OK With Watchful Waiting Over Tests

Satisfaction, anxiety similar after different approaches to unexplained complaints

THURSDAY, March 19 (HealthDay News) -- Watchful waiting as opposed to ordering blood tests for patients with unexplained complaints was not associated with increased patient anxiety or decreased satisfaction, according to research published in the March/April Annals of Family Medicine.

Marloes A. van Bokhoven, M.D., Ph.D., of Maastricht University in the Netherlands, and colleagues analyzed data from 498 patients with unexplained fatigue, weight change, pruritus, or abdominal or musculoskeletal complaints. Physicians either immediately ordered blood tests or suggested four weeks of watchful waiting, and patients answered questionnaires after the consultation.

No difference was seen between the groups in terms of anxiety or satisfaction, the investigators found. Increased satisfaction, however, was associated with feeling that they had been taken seriously (odds ratio, 7.56), and decreased satisfaction was linked with thinking that the physician found their complaints bearable (odds ratio, 0.30). A greater chance of anxiety was linked to having a sense that the physician was certain that the complaint was not a cause of alarm (odds ratio, 2.37).

The main finding of the study "is especially remarkable as patient satisfaction and anxiety are important factors in primary care physicians' decisions about ordering tests. Apparently, primary care physicians overestimate the effects of additional testing in patients seeking care for unexplained complaints and underestimate how much they themselves can contribute to the well-being of their patients by discussing their worries," the authors write.

The study was funded in part by the Dutch College of Health Care Insurances and a health insurance company.

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