Preferences of patients for patient centred approach to consultation in primary care: observational studyBMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7284.468 (Published 24 February 2001) Cite this as: BMJ 2001;322:468
- Paul Little, clinician scientist ()a,
- Hazel Everitt, research fellowa,
- Ian Williamson, senior lecturera,
- Greg Warner, general practitionerb,
- Michael Moore, general practitionerc,
- Clare Gould, research assistanta,
- Kate Ferrier, medical studenta,
- Sheila Payne, director of health research unitd
- a Primary Medical Care Group, Community Clinical Sciences Division, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST
- b Nightingale Surgery, Romsey, Hampshire SO51 7QM
- c Three Swans Surgery, Salisbury, Wiltshire SP1 1DX
- d Health Research Unit, School of Health Professions and Rehabilitation Sciences, Southampton University
- Correspondence to: P Little
- Accepted 2 December 2000
Objective: To identify patient's preferences for patient centred consultation in general practice.
Design: Questionnaire study.
Setting: Consecutive patients in the waiting room of three doctors' surgeries.
Main outcome measures: Key domains of patient centredness from the patient perspective. Predictors of preferences for patient centredness, a prescription, and examination.
Results: 865 patients participated: 824 (95%) returned the pre-consultation questionnaire and were similar in demographic characteristic to national samples. Factor analysis identified three domains of patient preferences: communication (agreed with by 88-99%), partnership (77-87%), and health promotion (85-89%). Fewer wanted an examination (63%), and only a quarter wanted a prescription. As desire for a prescription was modestly associated with desire for good communication (odds ratio 1.20; 95% confidence interval 0.85 to 1.69), partnership (1.46; 1.01 to 2.09), and health promotion (1.61; 1.12 to 2.31) this study may have underestimated preferences for patient centredness compared with populations with stronger preferences for a prescription. Patients who strongly wanted good communication were more likely to feel unwell (very, moderately, and slightly unwell; odds ratios 1, 0.56, 0.39 respectively, z trend P<0.001), be high attenders (1.70; 1.18 to 2.44), and have no paid work (1.84; 1.21 to 2.79). Strongly wanting partnership was also related to feeling unwell, worrying about the problem, high attendance, and no paid work; and health promotion to high attendance and worry.
Conclusion: Patients in primary care strongly want a patient centred approach, with communication, partnership, and health promotion. Doctors should be sensitive to patients who have a strong preference for patient centredness—those vulnerable either psychosocially or because they are feeling unwell.
Funding NHS Research and Development South West and South East Regions. PL is funded by the MRC.
Competing interests None declared.
- Accepted 2 December 2000