Enablement After Consultation in Primary Healthcare: How Do Patients and Doctors Cross-Sectionally Evaluate It in...

The degree to which patients are able to understand, cope with, and manage their illness and daily lives can be assessed using the Patient Enablement Instrument (PEI) questionnaire, a tool widely recognized as the gold standard for such evaluations. The primary objective of this study was to assess the level of agreement between patients and General Practitioners (GPs) in evaluating enablement following a consultation.

A cross-sectional observational study was carried out using the PEI in urban area, (3,88% of patients without GP). Surveys were conducted with individuals over 18 years of age after their GP appointment. They were invited post-consultation to self-complete the PEI survey (range: 0-12) and sociodemographic questionnaire, following the written informed consent. Both patients and GPs completed the PEI. A minimum sample size of 108 participants was calculated, and a favourable opinion was obtained from the Ethics Committee of the Faculty of Medicine of the University of Porto (FMUP).

The study included 16 physicians and 238 patients (65.1% women, median age 59). Patients reported higher levels of enablement than GPs (median 8 vs 6), with a mean bias of 0.89. The agreement between the patients and the GPs was poor (42%-46%), and the reliability of the total score across the six PEI items (intraclass correlation coefficient: 0.126) was low.

In this sample, GPs underestimated patients' perceived enablement levels. Enablement is multidimensional and depends on various clinical interactions and care processes. Factors influencing enablement and its impact on disease self-management and health outcomes should be explored in future research.