General practitioners’ perceptions of treatment of chronically ill patients managed in general practice: An interview study

Marcussen, Michael; Titlestad, Signe Beck; Lee, Kim; Bentzen, Niels; Søndergaard, Jens; Nørgaard, Birgitte

doi:10.1080/13814788.2021.1932810

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…Across studies and perspectives, our findings indicate that time at consultation, relational continuity, and a good GP–patient relationship are important for providing and facilitating patient involvement. These findings align with research showing that continuity in care, a supportive consultation environment with a warm and caring GP, and a good patient–GP interaction is significant in chronic disease management [ 14 , 37 ].…”

Section: Discussionsupporting

confidence: 85%

“…All aspects of data collection, extraction, and analysis were carried out independently by two researchers, with a third party available for mediation in cases of disagreements. The primary limitation of this scoping review is the sparse literature related to our objectives that may be caused by choice to focus on chronic obstructive pulmonary disease (COPD) and type 2 diabetes (TD2) as they are the two most prevalent chronic conditions that are managed by GPs in Western countries [ 14 , 15 , 46–48 ]. On the other hand, no results were found to suggest that the perspectives of patients with COPD and type 2 diabetes regarding involvement should differ considerably from those of patients suffering from other chronic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…However, analyses of chronic diseases patients’ involvement in their encounters with general practice appear to be lacking. We chose to focus on chronic obstructive pulmonary disease (COPD) and type 2 diabetes (TD2) as they are the two most prevalent chronic conditions that are managed by GPs in Western countries [ 14 , 15 ]. In a situation where policymakers continue to push for the adoption of patient involvement in general practice of patients with COPD and TD2 [ 13 ], there is an urgent need to remedy the lack of knowledge in this field.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease

Titlestad

Marcussen

Rasmussen

et al. 2022

European Journal of General Practice

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Introduction Research has shown improved health outcomes when patients are involved in managing their health conditions and when their individual needs are considered. Objectives This scoping review aimed to map the existing research regarding chronic disease patients’ involvement in their encounters with general practice, with a specific focus on patients with Type 2 diabetes (TD2) or chronic obstructive pulmonary disease (COPD) and from the perspectives of both general practitioners and patients. Methods Studies of any design, date, and language were included. A systematic search was conducted using the following databases: Medline, CINAHL, PsycInfo, Scopus, and EMBASE from August until October 2020 and renewed September 2021. Data were systematically charted by the following study characteristics: bibliographic aims; study aims; setting; area of interest; results; conclusion. Results Eighteen studies were included; they conducted qualitative methods, surveys or mixed methods. From the patients’ perspectives, the importance of being more involved in treatment discussions during consultations as well as a friendly environment, was underscored. A good relationship and relational continuity make it easier for patients to be more involved in treatment decisions. From the general practitioner (GP) perspectives, they mentioned their high workload, long-standing relationships, knowledge about the patients and prepared patients as factors influencing their ability to involve patients in treatment discussions. Conclusion A good GP–patient relationship was considered an important aspect to providing and facilitating for involvement of patients with COPD or TD2. Scoping review registration: https://osf.io/ynqt2

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease

Titlestad

Marcussen

Rasmussen

et al. 2022

European Journal of General Practice

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“…Both groups found that recruitment to a cohort should take place through the GPs. Our results thus corroborate the perception of the GP as being a gatekeeper and treatment coordinator for patients with chronic diseases – roles that contribute to both safety and compliance in terms of following the treatment due to a long-standing and trusting GP–patient relationship [ 19 – 21 ]. However, other studies highlight that GPs’ high workload should be considered [ 22 – 24 ], particularly when new tasks are added.…”

Section: Discussionsupporting

confidence: 83%

User perspectives on systematic data collection regarding back pain managed in general practice – a qualitative study

Morgan

Kongsted

Nørgaard

2022

BMC Musculoskelet Disord

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Background Back pain is a main driver of disability and the most prevalent reason why people in Demark visit a general practitioner (GP). However, little is known about back pain management in primary care. For new strategies to be sustainable and to accommodate the recommendations for evidence-based practice, patients’ perspectives are paramount to complement clinical expertise and research evidence. This study aimed to identify recommendations for systematic data collection in a nationwide cohort regarding the management of back pain in general practice from the perspectives of GPs and patients. Method We applied an adapted exploratory sequential design using focus groups and individual interviews. Seven GPs and ten patients with back pain participated, and four focus groups and seventeen individual interviews were conducted. Data were analyzed using abductive reasoning. Results Both GPs and patients with back pain found that 1) recruitment to a cohort should take place through the GPs, 2) the heterogeneity of patients with back pain and their need for individualized treatment and care should be considered, and 3) data from the cohort should feed into a flowchart or guideline to illustrate a generic patient pathway and visually assist both the patient and GP to obtain an overview and, thus, structure the patient pathway. Conclusion GPs and patients with back pain both considered the nationwide cohort with the overall aim to investigate back pain management as being extremely relevant in relation to improve t the patient pathway. User perspectives should be explored and integrated into health care interventions.

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“…General practice (GP) plays a key role in managing the clinical pathways of patients with chronic diseases. 1 For general practitioners (GPs), this role is primarily regarded as burdensome and challenging. 2 However, being diagnosed with a chronic disease also includes multiple challenges for the patients, including the struggle to manage everyday life with a chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Patients' perspectives on involvement in general practice: A thematic analysis of free‐text comments

Nørgaard

Titlestad

Marcussen

2023

Evaluation Clinical Practice

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Background: General practice (GP) plays a core role in managing the clinical pathways of patients with chronic diseases. Despite well-established knowledge of the benefits of involvement and personalized care, involvement in GP appears to be challenged. This study aimed to explore patient involvement in GP from the patients' perspectives. Method:The study involved a questionnaire survey investigating patient involvement in GP from the patients' perspectives. The validated questionnaire includes an open-ended question encouraging responders to provide additional comments regarding their involvement in GP. The results from these comments are presented in this paper. A thematic analysis was applied.Results: Of the 468 responses, 139 included additional comments to the free-text question. Through our analysis, six analytic themes were generated-To be seen, met or heard, To feel safe or not, To be involved or dictated to, Accessibility, COVID-19, and For the resourceful-across 116 codings and 25 descriptive themes. The themes' interwovenness underscores the complexity of both involvement and how it is to live with a chronic disease. Our analysis indicates that involvement in GP is for the resourceful. Conclusion:The six themes describing involvement in GP from the perspectives of patients with T2DM and/or COPD were deeply intertwined. Involvement is dependent on being seen, met and heard, all of which contribute to the patients' sense of feeling safe (or not). These aspects are dependent on accessibility to a general practitioner; thus, COVID-19 was a barrier during the data-collection period.Furthermore, it appeared that being resourceful not only contributed to a sense of being involved in GP but was perhaps even a prerequisite for being involved.

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General practitioners’ perceptions of treatment of chronically ill patients managed in general practice: An interview study

Cited by 5 publications

References 19 publications

Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease

Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease

User perspectives on systematic data collection regarding back pain managed in general practice – a qualitative study

Patients' perspectives on involvement in general practice: A thematic analysis of free‐text comments

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