Ietje Perfors

58 Chapter 3 Patient perception Positive effects on patients’ satisfaction with care were indicated by three studies. Extended information by PHR or discharge summary improved patient perceived intersectoral cooperation. 16, 17 GP consultations were evaluated as useful. Also patients reported that ‘the GP could help in the way a specialist could not’. 26 Regardless of the uptake of the intervention, one study showed an improved satisfactionwith communication and participationwith care. 25 The significantly higher levels of perceived GP support shortly after the intervention described in Nielsen et al 16 declined to non-significant levels at six months after start of intervention. The authors did not present a mean difference overtime. One study with a low uptake of intervention showed no significant effect on patients satisfaction. 21 Quality of life and psychological outcomes No study found a significant effect on quality of life. 16, 18, 25 Johnson et al, 26 showed a significant difference in change of depression scores (p0.04). In the intervention group, depression scores remained unchanged, whereas scores in the control group, deteriorated significantly. Also, using a PHR combined with routine visits to the GP led to a significantly higher reduction of the number of clinically anxiousness patients compared with usual care. 26 GPs perceptions of care Four out of five studies evaluating effects on GPs perceptions of care did not find relevant effects on GP’s confidence in disease management and knowledge nor in the communication with the specialist. 17, 21, 24, 26 Studies in which information was carried by the patient (a PHR or informational cards) showed little impact on GP satisfaction with care mostly due to low uptake of intervention. Only Nielsen/Kousgaard et al 16, 17 found significant positive effects on GP perceived intersectoral cooperation and GP satisfaction with information.