Measuring change in health in general practice: a comparison of a simple transition question with the Nottingham Health Profile

Objective. To compare a simple transition question with a standard measure of distress [the Nottingham Health Profile (NHP)] in the measurement of change in health of patients attending general practitioners. Setting and subjects. Two hundred and thirty one patients attending for acute or chronic illness, or follow-up consultations in a single general practice. Measures. Patients completed the NHP at the consultation and again after 2 weeks. They also completed the transition question after 2 weeks, which asked how the patient felt in comparison with 2 weeks before. In addition, patients in the chronic category were reviewed at 2 weeks by the general practitioner. Analysis sought the level of agreement between the changes in NHP scores and the transition question responses. Results. Levels of correlation between changes in NHP scores and the transition question were low, and for patients with chronic illness correlation was only moderate between the transition question and the general practitioner's assessment. The transition question was less sensitive to deterioration in health. Conclusions. Caution is required in the interpretation of findings from the use of simple transition questions that ask patients how they feel. Further evaluation of transition questions with different wording and format is required.