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Findings from a feasibility study to improve GP elicitation of patient concerns in UK general practice consultations
Authors:Geraldine M. Leydon  Beth Stuart  Rachael H. Summers  Paul Little  Stuart Ekberg  Fiona Stevenson  Carolyn A. Chew-Graham  Lucy Brindle  John Heritage  Paul Drew  Michael V. Moore
Affiliation:1. Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, UK;2. NHS Digital, Leeds, West Yorkshire, UK;3. Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia;4. E-Health Unit, Primary Care & Population Health, University College London, UK;5. Primary Care & Health Sciences, Keele University, UK;6. Faculty of Health Sciences, University of Southampton, UK;g. Social Sciences, University of California at Los Angeles, USA;h. Social Sciences, Loughborough University, UK
Abstract:

Objectives

To establish: a) feasibility of training GPs in a communication intervention to solicit additional patient concerns early in the consultation, using specific lexical formulations (“do you have ‘any’ vs. ‘some’ other concerns?”) noting the impact on consultation length, and b) whether patients attend with multiple concerns and whether they voiced them in the consultation.

Methods

A mixed-methods three arm RCT feasibility study to assess the feasibility of the communication intervention.

Results

Intervention fidelity was high. GPs can be trained to solicit additional concerns early in the consultation (once patients have presented their first concern). Whilst feasible the particular lexical variation of ‘any’ vs ‘some’ seemed to have no bearing on the number of patient concerns elicited, on consultation length or on patient satisfaction. The level of missing questionnaire data was low, suggesting patients found completion of questionnaires acceptable.

Conclusion

GPs can solicit for additional concerns without increasing consultation length, but the particular wording, specifically ‘any’ vs. ‘some’ may not be as important as the placement of the GP solicitation.

Practice implications

GPs can solicit early for additional concerns and GPs can establish patients’ additional concerns in the opening of the consultation, which can help to plan and prioritise patients multiple concerns.
Keywords:Agenda setting  Feasibility study  Communication  General practice consultations  Eliciting patients multiple concerns
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