Agreement between self-reported co-morbidity of visually impaired older patients and reports from their general practitioners

Purpose: In visually impaired older patients, it is unclear which co-existing conditions patients suffer from and whether all co-existing conditions are reported by the patient. Our purpose was to present the level of agreement between patients' and their general practitioners' co-morbidity reports.

Methods: Analyses were performed on data from an observational study among 296 visually impaired older patients. Agreement between patients and 165 general practitioners was obtained from twelve (chronic) condition categories. Cohen's Kappa was used to assess the level of agreement.

Results: Patients reported a median number of co-existing conditions of 1 (range: 0-4) and general practitioners 3 (range: 0-7). Agreement was 'very good' for diabetes (Kappa 0.82; 95% CI [0.73;0.92]) and 'moderate' for heart conditions (Kappa 0.48; 95% CI [0.33;0.62]) and COPD or asthma (Kappa 0.60; 95% CI [0.45;0.75]). Kappa values were 'fair' (0.29 to 0.34) for cancer, musculo-skeletal conditions, hearing impairments and stroke, and 'poor' (-0.01 to 0.18) for psychological problems, chronic skin problems, gastrointestinal conditions, chronic allergies, thyroid gland conditions and hypertension.

Conclusions: Agreement between patients and their general practitioners differed per condition, but was for most conditions poor to fair. Rehabilitation services, ophthalmologists and rehabilitation researchers should be aware that patients often under report co-morbidity. We recommend using medical charts or asking visually impaired older patients for co-existing conditions using pre-structured questionnaires in order to obtain a more complete view of the patient's health status.