Results of large patient surveys performed in different countries suggest that patients expect to receive good counselling, to be extensively informed and to get enough time and possibilities to communicate their concerns when visiting a physician. In some countries, this has resulted in reimbursing the provision of a “therapeutic conversation”, which goes beyond the usual consideration of the patient’s medical history. The same is true for Austria, where the therapeutic conversation is reimbursed up to a certain limit.

The assessment aimed at providing a systematic review of the existing literature with regard to the effects of a therapeutic conversation. Several outcome parameters were investigated to answer the following question: Does the therapeutic conversation result in improvement of the quality of care offered in physicians’ practices? The outcome parameters analyzed were attainment of therapeutic goals, patients’ compliance, participation, self-management, satisfaction as well as a reduction of additional health care costs.

The review included primarily high-quality studies (RCTs and systematic reviews of RCTs). Additionally, cohort studies, observational studies and several qualitative studies were identified. Overall, 49 publications were considered for the assessment.Reasonable evidence was found for the effectiveness of the therapeutic conversation on patients’ self-management and satisfaction. For specific diseases/disorders, a reduction in additional health care costs was reported. For theremaining outcome parameters, evidence was less convincing.

The report also covers reimbursement regulations in selected countries. In the final chapter, some options for maintaining or extending the coverage are discussed, taking into account the existing study results and the problems of transferring these results to the real care situation in Austria.