Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study

Abstract

M.Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: a qualitative study.Patient Education and Counseling http://dx.doi.org/10.1016/j.pec. 2015.12.005 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract ObjectiveTo investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation. MethodsEighteen GPs participating in a feasibility randomised controlled trial were interviewed.Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach. ResultsParticipants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice.Nevertheless, soliciting ACs in every consultation was not unanimously supported. ConclusionThe prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations. Practice implicationsSome GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively.

A qualitative study of GP, nurse and practice manager views on using targeted case-finding to identify patients with COPD in primary care

“…There was a frequently expressed need for additional resources and support to enable practices to engage in targeted case-finding initiatives and to cater for those patients identified as a result, as reported by Haroon et al 18 This is perhaps unsurprising given the considerable increase in demand for primary care appointments 21 and the general staffing and resource challenges currently facing GP practices. 22 , 23 Like Haroon et al 18 participants, our interviewees were concerned that their already over-burdened practices would not have capacity to meet the needs of a patient population expanding due to an increase in diagnosed COPD; with capacity to perform yearly reviews being of particular concern.…”