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Clinical Trial
. 2004 Sep;54(506):663-6.

Eliciting patients' concerns: a randomised controlled trial of different approaches by the doctor

Malcolm McLean  1 , David Armstrong
Affiliations
Clinical Trial

Eliciting patients' concerns: a randomised controlled trial of different approaches by the doctor

Malcolm McLean et al. Br J Gen Pract. 2004 Sep.

Abstract

Background: Although a 'patient-centred' approach to general practice consultation is widely advocated, there is mixed evidence of its benefits.

Aim: To measure the costs and benefits of using a prompt to elicit patients' concerns when they consult for minor illness.

Design of study: An open randomised controlled trial.

Setting: Four training semi-rural general practices in the south- east of the United Kingdom.

Method: Patients identified during the first part of the consultation as having a self-limiting illness were randomised to a second part of the consultation that was conducted 'as usual' or involved a written prompt to elicit the patient's concerns. After each consultation the doctor noted the diagnosis and the consultation length and the patient self-completed a questionnaire containing measures of satisfaction, enablement and anxiety.

Results: One hundred and ten patients were studied. Patients in the elicitation group reported a small but significant increase in the 'professional care' score of the consultation satisfaction questionnaire (88.2 versus 80.9, mean difference = 7.3, 95% confidence interval = 2.0 to 12.6) but no other benefits were detected. Consultations in the elicitation group, however, were longer by about a minute.

Conclusion: Given the pressures on consultation time in general practice there must be questions about the practical value of eliciting patients' concerns if the benefit of doing so is small and the cost large.

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Figures

Figure 1
Figure 1
Modelled recruitment flow chart.
See this image and copyright information in PMC

Comment in

  • Eliciting patients' concerns.
    Paterson C. Paterson C. Br J Gen Pract. 2004 Dec;54(509):945; author reply 945-6. Br J Gen Pract. 2004. PMID: 15588542 Free PMC article. No abstract available.
  • Eliciting patients' concerns.
    Middleton J. Middleton J. Br J Gen Pract. 2004 Dec;54(509):945; author reply 945-6. Br J Gen Pract. 2004. PMID: 15696624 Free PMC article. No abstract available.
  • Eliciting patients' concerns.
    Bonnar B. Bonnar B. Br J Gen Pract. 2004 Dec;54(509):945; author reply 945-6. Br J Gen Pract. 2004. PMID: 15696625 Free PMC article. No abstract available.

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