Exploring patients' views of primary care consultations with contrasting interventions for acute cough: a six-country European qualitative study.
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ABSTRACT: Background
In a pan-European randomised controlled trial (GRACE INTRO) of two interventions, (i) a point-of-care C-reactive protein test and/or (ii) training in communication skills and use of an interactive patient booklet, both interventions resulted in large reductions in antibiotic prescribing for acute cough.Aims
This process evaluation explored patients' views of primary care consultations using the two interventions in six European countries.Methods
Sixty-two interviews were conducted with patients who had participated in the GRACE INTRO trial. Interviews were transcribed verbatim and translated into English where necessary. Analysis used techniques from thematic and framework analysis.Results
Most patients were satisfied with their consultation despite many not receiving an antibiotic. Patients appeared to accept the use of both intervention approaches. A minority, but particularly in the trial arm with both interventions, reported that they would wait longer before consulting for cough in future.Conclusions
Patients perceived that both interventions supported the general practitioner's (GP's) prescribing decisions by helping them understand when an antibiotic was, and was not, needed. Patients consulting with acute cough had largely positive views about the GP's enhanced communication skills, which included understanding their concerns, and the use of a near-patient test as an additional investigation.
SUBMITTER: Tonkin-Crine S
PROVIDER: S-EPMC4373386 | biostudies-literature | 2014 Jul
REPOSITORIES: biostudies-literature
Publications
Exploring patients' views of primary care consultations with contrasting interventions for acute cough: a six-country European qualitative study.
Tonkin-Crine Sarah S Anthierens Sibyl S Francis Nick A NA Brugman Curt C Fernandez-Vandellos Patricia P Krawczyk Jaroslaw J Llor Carl C Yardley Lucy L Coenen Samuel S Godycki-Cwirko Maciek M Butler Christopher C CC Verheij Theo J M TJ Goossens Herman H Little Paul P Cals Jochen W JW
NPJ primary care respiratory medicine 20140717
<h4>Background</h4>In a pan-European randomised controlled trial (GRACE INTRO) of two interventions, (i) a point-of-care C-reactive protein test and/or (ii) training in communication skills and use of an interactive patient booklet, both interventions resulted in large reductions in antibiotic prescribing for acute cough.<h4>Aims</h4>This process evaluation explored patients' views of primary care consultations using the two interventions in six European countries.<h4>Methods</h4>Sixty-two inter ...[more]
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Project description:ObjectivesTo explore the views of commissioners, service development leads, service managers and senior staff in selected dementia services on increasing the role of primary care in postdiagnostic support for people with dementia.DesignQualitative semi-structured telephone interviews and a focus group.SettingParticipants were drawn from National Health Service (NHS) Clinical Commissioning Groups, social care commissioning and a range of dementia services across primary care, secondary mental healthcare, social care and the third sector. All participants were based in England or Wales.Participants61 professionals, comprising 25 commissioners or service development leads; 25 service managers; and 11 team leads or senior staff.ResultsParticipants had varied views on whether a primary care-based approach for postdiagnostic support for people with dementia and their families was appropriate, achievable and/or desirable. Potential benefits of a task-shifted approach were continuity and a more holistic approach to care; familiarity for both patients and staff; and reduction of stigma. Key challenges included the capacity, ability and inclination of primary care to deliver postdiagnostic support for people with dementia and their families. We discovered a number of conceptual challenges to implementing a task-shifted and task-shared approach, including uncertainties around the nature of postdiagnostic support, the definition of primary care and identification of tasks that could be shifted to primary care.ConclusionsOur data highlight the concerns of key professional staff around greater involvement of primary care in postdiagnostic support for dementia. Further research is needed to achieve a shared understanding and consensus over what postdiagnostic support means in the context of dementia. We will be undertaking such research in the next phase of our programme.
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