The person-based development and realist evaluation of a summary report for GP consultations

Murphy, Mairead; Wong, Geoff; Scott, Anne; Wilson, Victoria; Salisbury, Chris

doi:10.3310/nihropenres.13258.1

Cited by 2 publications

(8 citation statements)

References 36 publications

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“…The process evaluation is presented in the following sections. section 4.2 gives a summary of the interview participants and section 4.3 gives a brief summary of the realist evaluation, which is presented in more detail in the two linked papers 13,14 . section 4.4 presents some contextual factors affecting the implementation from the GP and patient perspectives.…”

Section: Discussionmentioning

confidence: 99%

“…The COAC intervention development study was carried out immediately prior to this study and is published in two linked papers 13,14 . Both parts of the intervention (the pre-consultation form at opening and the summary report at closing) were developed and tested separately, according to Medical Research Council (MRC) guidance 15 .…”

Section: Coac Intervention Development Studymentioning

confidence: 99%

“…The patient-facing summary report was developed in consultation with a patient and public involvement (PPI) group and tested iteratively using a person-based approach. The final summary report had two sub-headings as follows: An example of the pre-consultation form and summary report are shown in Figure 1 and Figure 2 (reproduced from the two linked papers on development and testing of the pre-consultation form 14 and summary report 13 respectively.…”

Section: Coac Intervention Development Studymentioning

confidence: 99%

“…Realist evaluation is a theory-driven approach which aims to identify core theories about how a programme is supposed to work and test them out to see if they are plausible, practical and valid. The full realist evaluation answers research question 5 and is reported in two linked papers: one for the realist evaluation of the pre-consultation form 14 and one for the realist evaluation of the summary report 13 .…”

Section: Process Evaluationmentioning

confidence: 99%

“…As above development study to inform intervention design. Their input and the impact of this is described in the two linked papers 13,14 .…”

Section: As Abovementioning

confidence: 99%

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The consultation open and close study: A feasibility study of a complex intervention

et al. 2022

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Background: Use of telephone, video and online consultations in general practice is increasing. This can lead to transactional consultations which make it harder for patients to describe how symptoms affect their lives, and confusion about plans for future care. The aim of this study was to test the feasibility of a randomised control trial (RCT) for a complex intervention designed to address patients’ concerns more comprehensively and help them remember advice from general practitioners (GPs). Methods: The complex intervention used two technologies: a patient-completed pre-consultation form at consultation opening and a doctor-provided summary report printed or texted at consultation closure. The feasibility of the intervention was tested in a cluster-randomised framework in six practices: four randomised to intervention, and two to control. Thirty patients were recruited per practice. Quantitative data was collected via patient-reported questionnaires and health records. GPs, patients and administrators were interviewed. Analysis included a process evaluation, recruitment and follow-up rates, and data completeness to assess feasibility of a future RCT. Results: The intervention was acceptable and useful to patients and GPs, but the process for the pre-consultation form required too much support from the researchers for a trial to be feasible. Both technologies were useful for different types of patients. Recruitment rates were high (n=194) but so was attrition, therefore criteria to progress to an RCT were not met. Conclusions: Both the pre-consultation form and the summary report showed important potential benefits. They should be considered as separate interventions and evaluated independently. The technology to send pre-consultation forms needs further development to allow integration with GP computer systems. The additional time needed to generate summary reports meant GPs preferred to use it selectively. Collecting outcome data using online questionnaires was efficient but associated with high attrition, so alternative approaches are needed before a full RCT is feasible.

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Section: Discussionmentioning

confidence: 99%

Section: Coac Intervention Development Studymentioning

confidence: 99%

Section: Coac Intervention Development Studymentioning

confidence: 99%

Section: Process Evaluationmentioning

confidence: 99%

“…As above development study to inform intervention design. Their input and the impact of this is described in the two linked papers 13,14 .…”

Section: As Abovementioning

confidence: 99%

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The consultation open and close study: A feasibility study of a complex intervention

et al. 2022

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Increased family psychosocial focus during children’s developmental assessments: a study of parents’ views

Strøyer de Voss,

Wilson,

Kirk Ertmann

et al. 2024

BMC Pediatr

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Background Family psychosocial challenges during the early years of a child’s life are associated with later mental and physical health problems for the child. An increased psychosocial focus on parents in routine child developmental assessments may therefore be justified. Methods Participants in this qualitative study included 11 mothers and one parental couple (mother and father) with children aged 9–23 months. Participants were recruited to Project Family Wellbeing through their general practice in Denmark. Twelve interviews were conducted, transcribed and analysed with a deductive approach. The topic guide drew on the core components of the Health Belief Model, which also served as a framework for the coding that was conducted using thematic analysis. Results Results are presented in four themes and 11 subthemes in total. Parents welcome discussion of their psychosocial circumstances during their child’s developmental assessments. Clinicians’ initiatives to address psychosocial challenges and alignment of parents’ and clinicians’ expectations may be required to allow this discussion. A flowing conversation, an open communication style and a trustful relationship facilitate psychosocial discussion. Barriers included short consultation time, concerns about how information was used and when parents found specific psychosocial aspects stigmatising or irrelevant to discuss. Conclusion Enquiry about the family’s psychosocial circumstances in routine developmental assessments is acceptable among parents. Alignment of clinical and parental expectations of developmental assessments could facilitate the process. Future research should examine the predictive validity of the various components of developmental assessments. Trial registration This is a qualitative study. The study participants are part of the cohort from Project Family Wellbeing (FamilieTrivsel). The project’s trial registry number: NCT04129359. Registered October 16th 2019.

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The person-based development and realist evaluation of a summary report for GP consultations

Cited by 2 publications

References 36 publications

The consultation open and close study: A feasibility study of a complex intervention

The consultation open and close study: A feasibility study of a complex intervention

Increased family psychosocial focus during children’s developmental assessments: a study of parents’ views

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