Outcomes and Patient Experience in Individuals With Longstanding Dizziness

Abstract

Purpose: This study aimed to describe the relationship between changes in pre and post self-perceived dizziness handicap, scores on the patient health questionnaire, and perceptions of patient's value of being evaluated and managed by a multidisciplinary team. Method: Seventy-eight patients completed the Dizziness Handicap Inventory (DHI) and Patient Health Questionnaire–Fourth Edition (PHQ-4) questionnaires post multidisciplinary clinical consultations and testing for the chief complaints of dizziness, unsteadiness, vertigo, or balance problems. The diagnoses of each patient were recorded from the clinical reports of each specialty consultation and were classified as structural, functional, or psychiatric. They were contacted by phone at least 6 months after their visit to obtain feedback regarding their symptoms and overall patient experience. Results: The change in DHI total score did not differ significantly by diagnosis ( p = .56), indicating that patients experienced an improvement in DHI total score regardless of diagnosis. PHQ-4 anxiety scores worsened by a mean of 0.7 points for those with structural diagnoses ( p = .04), improved by a mean of 0.7 points for psychiatric diagnoses ( p = .16), and improved by a mean of 0.3 points for functional diagnoses ( p = .39). Only seven patients would not recommend the team to a family or friend; these patients tended to report worsening DHI total scores ( p = .27) compared to the significant improvement in DHI total scores for patients who would make such a recommendation ( p < .001). Similarly, only 13 patients did not feel the information they received had a positive impact; these patients tended to report worsening DHI total scores ( p = .18) compared to the significant improvement in DHI total scores for patients who did feel the information had a positive impact ( p < .001). Discussion: The assessment and management of patients with chronic dizziness is challenging due to symptoms arising from multiple etiologies. Our finding of a vast difference between high satisfaction and relatively unchanged dizziness handicap suggests that there is value in seeing a multidisciplinary team where consultations are unhurried, care is coordinated, and expectations regarding treatment can be managed.