Patient Companionship in a Movement Disorders Clinic: Outside Assistance Inside the Office.

Ana Vives-Rodriguez,Elan D Louis,Daniel Trujillo Diaz

doi:10.3389/fneur.2019.00182

Abstract

Objective: We (1) report whether a companion (i.e., spouse, relative, aide) accompanied our consecutive outpatients with a range of movement disorders, (2) identified the set of patient characteristics that was associated with the need for a visit companion, and (3) characterized the role(s) of these companions during the visit. Our overarching goals were to further understand patient needs and the extent of their support networks, and to enrich the clinician-patient interface.Methods: Two-hundred consecutive patients were enrolled from the Movement Disorders Clinic at Yale School of Medicine. We noted whether patients were accompanied by another person during the visit and documented the role of the visit companion during the encounter.Results: One-hundred-twenty-eight of 200 patients (64.0%) brought a companion, with these being spouses (44.8%), adult children (24.1%) or an aide, nurse or social worker (14.5%). Patients who were unemployed (odds ratio [OR] = 5.32, p = 0.019), had a diagnosis of Parkinson's disease or other Parkinsonian syndromes (OR = 10.61, p = 0.001), or were dependent in any instrumental activities of daily living (iADLs) (OR = 4.99, p = 0.005) or basic activities of daily living (bADLs) (OR = 5.81, p = 0.02), had increased odds of presenting to the clinical visit with a visit companion. Visit companions' main roles involved communication (86.7%) and transportation (84.4%).Conclusion: Visit companions were commonly present during movement disorders outpatient visits–two-thirds of patients were accompanied. A number of factors increased the odds of requiring such a companion by 4- or 5-fold.

Highlights

Movement disorders (e.g., Parkinson’s disease [PD], essential tremor [ET]) are common neurological conditions that often affect motor independence [1, 2] and may be accompanied by cognitive difficulties [3] and behavioral comorbidities [4, 5]
Studies of family involvement during outpatient medical visits are few in number and mainly oriented toward patients in geriatric and primary care settings, [10, 11] some work has been done in neurology settings [12,13,14,15]
A visit companion was defined as a person 18 years or older who came to the clinic visit with the patient

Summary

Introduction

Movement disorders (e.g., Parkinson’s disease [PD], essential tremor [ET]) are common neurological conditions that often affect motor independence [1, 2] and may be accompanied by cognitive difficulties [3] and behavioral comorbidities [4, 5]. Studies of family involvement during outpatient medical visits are few in number and mainly oriented toward patients in geriatric and primary care settings, [10, 11] some work has been done in neurology settings [12,13,14,15]. These studies suggest an important role of family members both in enhancing patient-physician communication and in serving as agents of patient satisfaction with physician care [16]

Methods

Results

Discussion

Conclusion