PATIENT-BASED HEALTH-STATUS MEASUREMENT IN CLINICAL-PRACTICE - A STUDY OF ITS IMPACT ON EPILEPSY PATIENTS CARE

The objective was to assess the potential benefits of the routine use of the MOS SF-36 Health Survey (SF-36) in the care of ambulatory patie nts. The design was a longitudinal, prospective, randomized, controlle d study set in the outpatient neurology clinic at the New England Medi cal Center. There were 163 consecutive patients with epilepsy who had 210 follow-up visits with one of two epileptologists. The patients com pleted the SF-36 before the patient-physician encounter and the forms were optically scanned. The SF-36 results of the intervention group pa tients were given to the physicians before the encounter and withheld for control group patients. For intervention group patients, the physi cians completed a questionnaire assessing the impact of the SF-36 on t he process of care. After the visit, all patients completed a satisfac tion questionnaire. The main outcome measures were the physicians' res ponses to standardized questions about the usefulness of the SF-36 for communication with and management of epilepsy patients and the patien ts' responses to standardized questions about their satisfaction with care. The physicians indicated that the SF-36 provided new information in 63% of the intervention group encounters. A change in therapy was prompted in 13%. The physicians rated the SF-36 as at least moderately useful for communication in 14% of the encounters and to management i n 8%. The lower (indicating worse health status) the patients' SF-36 s cale scores, the more useful the SF-36 results were rated by the physi cians for communication and management. it was concluded that the rout ine use of health status measures may enhance patients' care.