Agenda Setting in Outpatient Consultation of Older Adults With Long-COVID

Agenda setting in doctor-patient interaction refers to the process when various agendas are presented and responded to. This study revealed how Long-COVID (LC) agenda items are managed by older adults and doctors during outpatient consultations.

Based on audio recordings, we adopted Conversation Analysis (CA) to unveil under what circumstances the patient or the doctor set the agenda and how they collaboratively work to develop an LC topic. Data was transcribed in accordance with the transcription conventions developed by Jefferson.

Agendas were divided into three categories, namely primary, additional, and unmet agenda items. LC agendas were identified with specific characteristics based on qualitative analysis and older adults tended to seek more medical assistance, particularly concerning their chronic diseases. We observed that patients initiate agendas more often than doctors and it could happen at any stage of the visit, both parties can resist expanding the agenda, mostly in an indirect way, and agendas that contain more information with simpler turn-constructions are more likely to be well-addressed.

Better quality of consultation was found when doctors sensitively detect the emotional change and the potential issues of the patients when they prevaricate to avoid the relevance of the previous infection. The findings also suggested that understanding the dynamics of agenda setting in consultations could lead to improvements in medical visit outcomes.

Patients and doctors in the study were colleagues in a university hospital. They were involved in various stages of this study to ensure it addresses real-world concerns and improves healthcare outcomes. Throughout data collection, patients contributed by allowing their consultations to be recorded and providing feedback on their experiences. Findings were discussed with a patient advisory group to ensure the interpretations aligned with patient perspectives. Doctors were also actively engaged in disseminating the results through later consultations, ensuring broad accessibility and practical application of the research outcomes.