Patients' Commitment to Their Primary Physician and Why It Matters

Berry, Leonard L.; Parish, Janet Turner; Janakiraman, Ramkumar; Ogburn-Russell, Lee; Couchman, Glen R.; Rayburn, William L.; Grisel, Jedidiah J.

doi:10.1370/afm.757

Cited by 128 publications

(100 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…34 Trusting one's doctor is also associated with having a commitment to this relationship 34 , which may help explain the paradox that MUS patients persist with GPs despite an impasse in treatment. It follows that developing trust between patient and physician allows for less conflictual discussion over issues such as uncertainty, disclosure of emotional distress and psychosocial issues.…”

Section: Discussionmentioning

confidence: 99%

What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms

et al. 2008

View full text Add to dashboard Cite

BACKGROUND: Despite both parties often expressing dissatisfaction with consultations, patients with medically unexplained symptoms (MUS) prefer to consult their general practitioners (GPs) rather than any other health professional. Training GPs to explain how symptoms can relate to psychosocial problems (reattribution) improves the quality of doctor-patient communication, though not necessarily patient health. OBJECTIVE:To examine patient experiences of GPs' attempts to reattribute MUS in order to identify potential barriers to primary care management of MUS and improvement in outcome.DESIGN: Qualitative study. PARTICIPANTS:Patients consulting with MUS whose GPs had been trained in reattribution. A secondary sample of patients of control GPs was also interviewed to ascertain if barriers identified were specific to reattribution or common to consultations about MUS in general. APPROACH: Thematic analysis of in-depth interviews.RESULTS: Potential barriers include the complexity of patients' problems and patients' judgements about how to manage their presentation of this complexity. Many did not trust doctors with discussion of emotional aspects of their problems and chose not to present them. The same barriers were seen amongst patients whose GPs were not trained, suggesting the barriers are not particular to reattribution.CONCLUSIONS: Improving GP explanation of unexplained symptoms is insufficient to reduce patients' concerns. GPs need to (1) help patients to make sense of the complex nature of their presenting problems, (2) communicate that attention to psychosocial factors will not preclude vigilance to physical disease and (3) ensure a quality of doctor-patient relationship in which patients can perceive psychosocial enquiry as appropriate.

show abstract

Section: Discussionmentioning

confidence: 99%

What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms

et al. 2008

View full text Add to dashboard Cite

show abstract

“…5 In a study on patients' preferences, patients stated that they believed that continuity of care improved their trust in their physician as well as their physician's ability to communicate health issues to them. 21 Although further research is needed to confirm the link between these attributes and continuity of care, in prior studies, better physician communication skills 22 and patients' trust in the provider 23,24 were associated with self-reported medication adherence.…”

Section: Discussionmentioning

confidence: 98%

Association between interpersonal continuity of care and medication adherence in type 2 diabetes: an observational cohort study

et al. 2017

View full text Add to dashboard Cite

CMAJ OPEN, 5(2) E359I nterpersonal continuity of care refers to the ongoing relationship between a patient and an individual physician. 1 There is good evidence from a systematic review that a high level of interpersonal continuity of care is associated with decreased hospital admissions and emergency department visits, and improved patient satisfaction.2 To what extent a high level of continuity of care is associated with a higher likelihood of medication adherence is less clear.2 Medication adherence consists of 2 main constructs: persistence (consistently refilling prescriptions for the prescribed length of time) and compliance (taking the drug in accordance with the prescribed dosage and schedule).3 To our knowledge, the relation between interpersonal continuity of care and medication adherence has been assessed in 6 studies. [4][5][6][7][8][9] In 4 of these studies, 4,7-9 a positive relation was observed. For example, a high level of continuity of care was associated with higher persistence with statins 8 and higher compliance with treatment with orally administered antidiabetics, 7 statins 9 and drugs used in heart failure.4 However, 5 of these studies 4,6-9 were limited by the fact that their design was cross-sectional. Therefore, the temporal relation between continuity of care and medication adherence could not be established.Patient adherence to oral antidiabetic treatment is not optimal. For example, in a study conducted in Quebec, 79% of patients were persistent with oral antidiabetic treatment 1 year after initiation of therapy; of the 79%, only 78% were compliant (obtained drug supplies for at least 80% of days during the year). Background: Prior studies have shown that, compared to patients with a low level of interpersonal continuity of care, patients with a high level of continuity of care have a lower likelihood of hospital admission and emergency department visits, and a higher likelihood of patient satisfaction. We sought to determine whether higher levels of continuity of care are associated with medication persistence and compliance among new users of oral antidiabetic treatment.

show abstract

“…While a number of barriers exist that make it difficult for clinicians to integrate nutrition counseling into routine practice [34], research shows that when they are able to overcome these obstacles, they have a positive impact on patient behaviors [32]. Many patients see their health care provider as a trusted reliable source of expert health information [33]. Practitioners can: raise awareness of the benefits of good nutrition through family meals together; encourage meal planning and family meals without the presence of TV; assess progress at future visits and provide positive reinforcement when this advice is taken; and share or suggest meal planning tools and apps, which are abundant on the internet, in bookstores and many grocery stores.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlates of Family Meals among Families of 3rd Graders

Davies¹,

Harrington²,

Fontaine³

et al. 2015

Arch Community Med Public Health

View full text Add to dashboard Cite

Introduction: Dietary intake has a significant role in promoting health and preventing disease. Family meals have been associated with higher nutrient intake, lower obesity rates, and other social benefits, yet little is known about what influences family meal frequency. Methods:We examined psychosocial and demographic factors potentially related to eating dinner together among families of third graders (N=1474) participating in "Hi5+," a family-and schoolbased nutrition program. Families were recruited from 33 schools to participate in a randomized trial to evaluate the efficacy of a fruit and vegetable promotion program.

show abstract

Patients' Commitment to Their Primary Physician and Why It Matters

Cited by 128 publications

References 57 publications

What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms

What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms

Association between interpersonal continuity of care and medication adherence in type 2 diabetes: an observational cohort study

Prevalence and Correlates of Family Meals among Families of 3rd Graders

Contact Info

Product

Resources

About