Older adults and their caregivers are more likely to agree on physical symptoms than psychological.
Patients and their caregivers were more likely to agree on the details or severity of pain, depression, and anxiety 50-60% of the time, says a recent study from the Regenstrief Institute and Indiana University School of Medicine.
The study looked at whether 576 adult patients and their proxies—family caregivers such as spouses or children—describe symptoms they’re experiencing and quality of life, which can affect the care they receive. Within this finding, they were more agreement on physical symptoms than psychological symptoms.
When looking at group averages, researchers also found that patients’ self-reports and caregiver reports were in line with each other because the information over, or under, reported averaged out.
“Unlike blood pressure and blood sugar, symptoms like pain, depression, or anxiety can’t be objectively measured,” Kurt Kroenke, MD, a faculty member within the IU School of Medicine and primary care physician, said in a release.
“Our group is very interested in symptoms—signs you can’t measure with an x-ray or a lab test. The only way to determine severity is with validated scales and if patients can’t report for themselves, then the proxy’s report is an important tool available to the clinician treating the patient.”
Caregivers tended to overestimate patient impairment at lower levels of symptom severity and underestimate it at higher levels. Caregivers under a lot of stress were found to be more likely to overreport the patient’s symptoms.
In situations where the patient is reporting this information themselves, additional information from their caregivers that agrees or disagrees with the original report may still be used when providers make treatment decisions, Kroenke added.
“Similar to what occurred during the pandemic, when we used rapid COVID tests rather than the more accurate PCR test to make decisions about travel or attending events or other issues, because rapid tests were the best we had on hand, when patients can’t complete a symptom scale, proxy reports, while not the best, are the best available and provide valuable information,” Kroenke said.
“The only way to determine severity is with validated scales and if patients can’t report for themselves, then the proxy’s report is an important tool available to the clinician treating the patient.”
Kurt Kroenke, MD, faculty member, IU School of Medicine
Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
50-60% of the time, patient and caregiver reports agreed on symptoms of pain, depression, and anxiety.
These reports were more likely to agree on physical symptoms than psychological symptoms.
Caregivers under a lot of stress were found to be more likely to overreport the patient’s symptoms.