Complex consultations in primary care: a tool for assessing the range of health problems and issues addressed in general practice consultations

Procter, S., Stewart, K. ORCID: 0000-0003-2529-954X, Reeves, D., Bowen, L., Purdy, S., Ridd, M. and Salisbury, C., 2014. Complex consultations in primary care: a tool for assessing the range of health problems and issues addressed in general practice consultations. BMC Family Practice, 15, p. 105. ISSN 1471-2296

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Abstract

Background: There is an increasing recognition that many consultations in general practice involve several problems covering multiple disease domains. However there is a paucity of reliable tools and techniques to understand and quantify this phenomenon. The objective was to develop a tool that can be used to measure the number and type of problems discussed in primary care consultations. Methods: Thirteen consultations between general practitioners and patients were initially videoed and reviewed to identify the problems and issues discussed. An iterative process involving a panel of clinicians and researchers and repeated cycles of testing and development was used to develop a measurement proforma and coding manual for assessment of video recorded consultations. The inter-rater reliability of this tool was assessed in 60 consultations. Results: The problems requiring action were usually readily identified. However the different dimensions of the problem and how they were addressed required the identification and definition of ‘issues’. A coding proforma was developed that allowed quantification of the numbers and types of health problems and issues discussed. Ten categories of issues were identified and defined. At the consultation level, inter-rater agreements for the number of problems discussed (within ±1), types of problems and issues were 98.3%, 96.5% and 90% respectively. The tool has subsequently been used to analyse 229 consultations. Conclusion: The iterative approach to development of the tool reflected the complexity of doctor-patient interactions. A reliable tool has been developed that can be used to analyse the number and range of problems managed in primary care consultations.

Item Type: Journal article
Publication Title: BMC Family Practice
Creators: Procter, S., Stewart, K., Reeves, D., Bowen, L., Purdy, S., Ridd, M. and Salisbury, C.
Publisher: BioMed Central
Date: 2014
Volume: 15
ISSN: 1471-2296
Identifiers:
NumberType
10.1186/1471-2296-15-105DOI
1081Publisher Item Identifier
Rights: © 2014 Procter et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Divisions: Schools > School of Science and Technology
Depositing User: Jonathan Gallacher
Date Added: 12 Apr 2017 08:25
Last Modified: 10 Oct 2017 15:16
URI: http://irep.ntu.ac.uk/id/eprint/30505

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