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Consultation length and chronic illness care in general practice: a qualitative study
C M Martin1, C L Banwell, D H Broom
1National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT. Carmel.Martin@dva.gov.au
The Medical Journal of Australia
|September 4, 1999
Summary
Longer general practice consultations allow patients with chronic conditions more time to discuss their illness and its impact. This patient-centered communication can improve management and patient enablement.
Area of Science:
- General Practice
- Chronic Disease Management
- Qualitative Research
Background:
- Understanding the dynamics of general practice consultations is crucial for effective chronic disease management.
- Previous studies have not fully explored the relationship between consultation duration and content for patients with complex chronic conditions.
Purpose of the Study:
- To investigate the association between the length and content of general practice consultations.
- To identify key themes and patient-centered communication elements within these consultations.
Main Methods:
- Qualitative analysis of 106 consultation transcripts from 14 general practitioners and 50 patients with chronic conditions in Australian practices.
- Thematic coding using the Ethnograph computer package to identify psychosocial support and patient narrative.
Main Results:
- General practitioners predominantly focused on disease management, including information provision and treatment/illness review.
- Longer consultations (≥20 minutes) featured increased patient-initiated dialogue and patient narrative regarding living with their illness.
- Key themes identified included GP information provision, treatment review, illness review, and patient illness descriptions.
Conclusions:
- Extended consultation times are potentially necessary for comprehensive illness and treatment review for patients with complex chronic conditions.
- Longer consultations can facilitate patient narrative, enabling them to discuss the impact of their illness and personal management strategies.
- This may contribute to enhanced patient enablement and a more holistic approach to chronic care.
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