Effect of patient completed agenda forms and doctors' education about the agenda on the outcome of consultations: randomised controlled trial

doi:10.1136/bmj.38841.444861.7C

BMJ 2006;332:1238-1242 (27 May), doi:10.1136/bmj.38841.444861.7C (published 17 May 2006)

Research

Effect of patient completed agenda forms and doctors' education about the agenda on the outcome of consultations: randomised controlled trial

J F Middleton, education consultant¹, R K McKinley, senior lecturer in general practice², C L Gillies, research associate²

¹ Leics, Northants and Rutland Deanery, University of Leicester, ² Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW

Correspondence to: R K McKinley rkm{at}le.ac.uk

Abstract

Objective To assess the effect of patient completed agenda formsfor the consultation and doctors' education on identifying patients'agendas on the outcome of consultations.

Design Randomised controlled trial.

Setting General practices in Leicestershire and Nottinghamshire,United Kingdom.

Participants 46 general practitioners and 976 patients.

Interventions Education for general practitioners, with an embeddedclustered randomised controlled trial of a patient agenda form.

Main outcome measures Number of problems identified, time requiredto manage each problem, duration of consultations, number ofproblems raised after the doctor considered the consultationfinished ("by the way" questions), and patient satisfaction.

Results Data were available from 45 doctors (98%) and 857 patients(88%). The number of problems identified in each consultationincreased by 0.2 (95% confidence interval 0.1 to 0.4) with theagenda form, by 0.3 (0.1 to 0.6) with education, and by 0.5(0.3 to 0.7) with both interventions. The time required to manageeach problem was not affected. The duration of consultationswith the agenda form was increased by 0.9 minutes (0.3 to1.5minutes) and with the combined intervention by 1.9 minutes (1.0to 2.8 minutes). Patient satisfaction with the depth of thedoctor-patient relationship was increased with the agenda form.The occurrence of "by the way" presentations did not change.

Conclusion A patient completed agenda form before the consultationor general practitioner education about the agenda form, orboth, enabled the identification of more problems in consultationseven though consultations were longer.

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