ArticleAnnals of family medicine
The unexpected in primary care: a multicenter study on the emergence of unvoiced patient agenda.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.BMC family practice · 2021Observational
- Antibiotic Prescribing and Doctor-Patient Communication During Consultations for Respiratory Tract Infections: A Video Observation Study in Out-of-Hours Primary Care.Frontiers in medicine · 2021Article
- The Impact of Previsit Contextual Data Collection on Patient-Provider Communication and Patient Activation: Study Protocol for a Randomized Controlled Trial.JMIR research protocols · 2020Article
- A Narrative Approach to Healing Chronic Illness.Annals of family medicine · 2018Article
- "Focusing" in Motivational Interviewing: development of a training tool for practitioners.European journal for person centered healthcare · 2018Article
- Patient-related factors influencing satisfaction in the patient-doctor encounters at the general outpatient clinic of the university of calabar teaching hospital, calabar, Nigeria.International journal of family medicine · 2012Article
- 'I didn't want her to panic': unvoiced patient agendas in primary care consultations when consulting about antidepressants.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- Organizational and market influences on physician performance on patient experience measures.Health services research · 2009Article
- Physician response to "by-the-way" syndrome in primary care.Journal of general internal medicine · 2009Article
- 'Well doctor, it is all about how life is lived': cues as a tool in the medical consultation.Mental health in family medicine · 2008Article
- The effect of patients' met expectations on consultation outcomes. A study with family medicine residents.Journal of general internal medicine · 2007Article
- Patient expectations from consultation with family physician.Croatian medical journal · 2006Article
- Patients satisfaction with consultation at primary health care centers in Abha City, Saudi Arabia.Journal of family medicine and primary careArticle
- In this issue: new model finances, systematic reviews, patients, and health care.Annals of family medicineArticle
- Predicting persistently high primary care use.Annals of family medicineArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWithin the time constraints of a typical physician-patient encounter, the full patient agenda will rarely be voiced. Unexpectedly revealed issues that were neither on the patient's list of items for discussion nor anticipated by the physician constitute an emerging agenda. We aimed to quantify the occurrence rate of emerging agendas in primary care practices and to explain the variation between patients and practices.
methodsThis observational cross-sectional study involved 182 primary care practices in 9 European cultural regions. Consecutive primary care consultations were videotaped and rated. Patients completed preconsultation and postconsultation questionnaires assessing their expectations and perceived care. Emerging agenda, determined by using 11-item preconsultation and postconsultation questionnaires, was defined as care perceived by the patient to be in addition to expected care, after adjustment for cultural variations of patient expectations.
resultsFor consultations involving 2,243 patients (mean age, 44.8 years, 58.4% women), every sixth (15.8%) consultation revealed emerging psychosocial agenda. Biomedical agenda emerged in 14.5% of the consultations. Rates for unmet expectations were 13.6% and 10.3%, respectively, for psychosocial and biomedical problems. Practices showed considerable heterogeneity of occurrence of emerging agenda (biomedical, median 13%, range 0%-67%; psychosocial, median 14%, range 0%-53%). After controlling for region and patient baseline characteristics, variables significantly related to emerging agenda were patient expectations and biomedical or psychosocial discourse content, but not consultation time or sex of the patient. A large proportion of the variance attributable to physicians remained concealed in a practice dummy variable (explaining up to 8% of the variance).
conclusionUnexpected agenda emerges in every sixth to seventh consultation in outpatient primary care visits.
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