Reasons for Encounter and Diagnosed Health Problems: Convergence Between Doctors and Patients

Britt, Helena; Harris, Margaret; Driver, Brian E.; Bridges‐Webb, C; O’Toole, Brian I.; Neary, Stephanie

doi:10.1093/fampra/9.2.191

Cited by 32 publications

(20 citation statements)

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“…For other subjects related to the consultation agreements ranging from 17% to 100% have been demonstrated (4,5,(10)(11)(12)(13)(14)(15)(16)(17). In our study agreement about all of the four topics examined was observed for only 35% of consultations.…”

Section: Discussioncontrasting

confidence: 43%

How well do patient and general practitioner agree about the content of consultations?

Fagerberg¹

1999

Scandinavian Journal of Primary Health Care

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Section: Discussioncontrasting

confidence: 43%

How well do patient and general practitioner agree about the content of consultations?

Fagerberg¹

1999

Scandinavian Journal of Primary Health Care

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“…Responses are recorded by the GP, about the patient, in discussion with the patient. Using a qualified medical practitioner to record morbidity in conjunction with the patient self-report may provide a more accurate classification of patients’ health problems than the self-report alone 16 17. A total of five SAND subsamples were used: three data collection periods were between January and October 2007; and two between January and March 2010.…”

Section: Methodsmentioning

confidence: 99%

Drugs causing adverse events in patients aged 45 or older: a randomised survey of Australian general practice patients

et al. 2013

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ObjectiveTo determine prevalence of adverse drug events (ADEs) in patients aged 45 years or older presenting to Australian general practitioners (GPs) and identify drug groups related to ADEs, their severity and manifestation.DesignSubstudy of the Bettering the Evaluation and Care of Health continuous survey of Australian GP clinical activity in which randomly selected GPs collected survey data from patients. Data are reported with 95% CIs.SettingGeneral practice in Australia.Main outcome measuresPrevalence in the preceding 6 months, type, implicated drugs, severity (including hospitalisation) and manifestation of ADEs.ParticipantsFrom three survey samples, January–October 2007, and two samples, January–March 2010, responses were received from 482 GPs about 7561 patients aged 45 years or older.ResultsOf a final sample of 7518 patients (after duplicate patients removed), 871 (11.6%) reported ADEs in the previous 6 months. The type of ADE was recognised side effect (75.8%, 95% CI 72.0 to 79.7), drug sensitivity (9.9%, 95% CI 7.2 to 12.7) and drug allergy (7.4%, 95% CI 4.7 to 10.1). Drug interaction (1.0%, 95% CI 0.1 to 1.8), overdose (0.8%, 95% CI 0.0 to 1.5) and contraindications (0.2%, 95% CI 0.0 to 0.6) were very infrequent. A severity rating was provided for 846 patients. Almost half (45.9%, 95% CI 42.0 to 49.7) were rated as ‘mild’ events, 42.2% (95% CI 38.8 to 45.6) ‘moderate’, 11.8% (95% CI 9.5 to 14.1) severe and 5.4% (95% CI 3.8 to 7.0) had been hospitalised as a result of the most recent ADE. Thirteen commonly prescribed drug groups accounted for 58% of all ADEs, opioids being the group most often implicated.ConclusionADEs in patients aged 45 or older are frequent and are associated with significant morbidity. Most of ADEs result from commonly prescribed drugs at therapeutic dosage. The list of causative agents bears little relationship to published lists of ‘inappropriate medications’.

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“…4,11,12 Patients are less likely to return for visits when there is a lack of physician-patient concordance, 13 although the relationship is inconsistent. 14,15 Trust is said to be essential to the medical consultation and is related to continuity and patient satisfaction. 16,17 The ability of the physician to enable the patient toward effective self-care is a marker of consultation quality.…”

Section: Physician-patient Relationship and Medication Compliancementioning

confidence: 99%

Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation

Kerse

Buetow²,

Mainous³

et al. 2004

The Annals of Family Medicine

303

220

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PURPOSEWe assessed the relationship between 4 attributes of the physicianpatient relationship and medication compliance. METHODSWe conducted a waiting room survey of patients consulting 22 general practitioners in 14 randomly selected practices in Auckland, New Zealand (81% response rate). A total of 370 consecutive patients (75% response rate) completed survey instruments about 4 attributes of the physician-patient relationship. Continuity of care (assessed from use of a usual physician, length of continuity, and perceived importance of continuity) and trust in the physician were ascertained before the consultation. After the consultation the Patient Enablement Index measured the physician's ability to enable patients in self-care, and concordance between the patient and physician was measured by a 6-item inventory of perceived agreement about the presenting problem and management, were ascertained immediately after the consultation. Compliance with prescribed medication therapy was ascertained by telephone follow-up 4 days after the consultation.RESULTS Overall, 220 patients (61%) received a prescription, and 79% of these patients were taking the medication at follow-up. In a univariate analysis adjusted for clustering, only trust and physician-patient concordance were signifi cantly related to compliance. In analysis further adjusted for health and demographic factors, physician-patient concordance was independently related to compliance (odds ratio = 1.34, 95% confi dence interval, 1.04-1.72).CONCLUSIONS Primary care consultations with higher levels of patient-reported physician-patient concordance were associated with one-third greater medication compliance. An emphasis on understanding and facilitating agreement between physician and patient may benefi t outcomes in primary care.

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Reasons for Encounter and Diagnosed Health Problems: Convergence Between Doctors and Patients

Cited by 32 publications

References 0 publications

How well do patient and general practitioner agree about the content of consultations?

How well do patient and general practitioner agree about the content of consultations?

Drugs causing adverse events in patients aged 45 or older: a randomised survey of Australian general practice patients

Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation

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