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- Title
The content and conduct of GP consultations for dermatology problems: a cross-sectional study.
- Authors
Le Roux, Emma; Edwards, Peter J; Sanderson, Emily; Barnes, Rebecca K; Ridd, Matthew J
- Abstract
<bold>Background: </bold>Skin complaints are common in primary care, and poor outcomes in long-term conditions are often due to low adherence to treatment. Shared decision making and self-management support may help, yet there is little understanding of patient involvement or the support provided by GPs.<bold>Aim: </bold>To describe the content of primary care consultations for skin problems, including shared decision making practice, delivery of self-management advice, and follow-up.<bold>Design and Setting: </bold>Cross-sectional study of video-recorded UK adult GP consultations and linked data.<bold>Method: </bold>A coding tool was developed and applied to all consultations with skin problems. Shared decision making was assessed using the observer OPTION5 scale.<bold>Results: </bold>A total of 45/318 consultations (14.2%) related to one or more skin problems, which were discussed alongside other problems in 71.1% (32/45) of consultations. Of the 100 different problems discussed in these consultations, 51 were dermatological. The mean amount of time spent on skin problems in the consultations was 4 minutes 16 seconds. Medication was recommended for 66.7% (34/51) of skin problems, with low shared decision making (mean OPTION5 score = 10.7). Self-management advice (verbal only) was given for 47.1% (24/51) of skin problems. Most skin problems (84.3%; 43/51) were not referred to secondary care; 32.6% (14/43) of the skin problems not referred were seen again in primary care within 12 weeks, of which 35.7% (5/14) follow-up appointments were not planned.<bold>Conclusion: </bold>In this study, skin problems were usually presented alongside other complaints and resulted in a medication recommendation. Shared decision making was uncommon and self-management advice not consistently given, with re-attendance for the same problem common. GPs' training should reflect how frequently skin problems are seen and seek to improve patient involvement in decision making and support self-management.
- Subjects
UNITED Kingdom; PATIENT compliance; SECONDARY care (Medicine); CROSS-sectional method; PATIENT decision making; PATIENT participation; DERMATOLOGY; DECISION making; MEDICAL referrals
- Publication
British Journal of General Practice, 2020, Vol 70, Issue 699, pe723
- ISSN
0960-1643
- Publication type
journal article
- DOI
10.3399/bjgp20X712577