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Patients' unvoiced agendas in general practice consultations: qualitative study
C A Barry1, C P Bradley, N Britten
1Department of General Practice and Primary Care, Guy's, King's, and St Thomas's School of Medicine, King's College, London SE11 6SP. christine.barry@brunel.ac.uk
BMJ (Clinical Research Ed.)
|May 8, 2000
Summary
Patients often do not voice all their health concerns during consultations. Unvoiced patient agendas can lead to poor health outcomes, highlighting the need for better communication in healthcare.
Area of Science:
- General Practice
- Patient-Doctor Communication
- Health Outcomes
Background:
- Patient consultations involve complex, multifarious agendas.
- Many patients do not voice all their concerns during medical appointments.
Purpose of the Study:
- To investigate patients' agendas before consultations.
- To assess which agenda aspects are voiced and the impact of unvoiced agendas on outcomes.
Main Methods:
- Qualitative study design.
- Conducted in 20 general practices across South East England and the West Midlands.
- Involved 35 patients consulting 20 general practitioners.
Main Results:
- Only 4 out of 35 patients voiced all their agendas.
- Commonly voiced items included symptoms and requests for diagnoses/prescriptions.
- Unvoiced items comprised worries, patient ideas about illness, side effects, and social context, often leading to misunderstandings, unwanted prescriptions, or non-adherence.
Conclusions:
- Unvoiced patient needs cannot be addressed, potentially leading to poor health outcomes.
- Articulating patient needs more fully in consultations may improve healthcare.
- Clinical practice and research should encourage the voicing of patient agendas.