ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
'I didn't want her to panic': unvoiced patient agendas in primary care consultations when consulting about antidepressants.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Shifting Perspectives on the Challenges of Shared Decision Making in Mental Health Care.Community mental health journal · 2024Pooled it
- Barriers and facilitators to GP-patient communication about emotional concerns in UK primary care: a systematic review.Family practice · 2020Pooled it
- Is ageism among prescribers an influential factor in the management of depression in the elderly? A vignette-based study.Family practice · 2026Article
- Factors associated with unvoiced concerns of patients attributed to embarrassment, modesty or a fear of being judged.BMC primary care · 2025Observational
- Beyond the medical file: A scoping review on patients' perspectives on depression treatment in primary care.PloS one · 2025Article
- Dose-response effects of selective serotonin reuptake inhibitor monotherapy for the treatment of depression: systematic review of reviews and meta-narrative synthesis.BMJ medicine · 2022Article
- Exploration of GP perspectives on deprescribing antidepressants: a qualitative study.BMJ open · 2021Article
- 'Doing the right thing': factors influencing GP prescribing of antidepressants and prescribed doses.BMC family practice · 2017Article
- 'She believed in me'. What patients with depression value in their relationship with practitioners. A secondary analysis of multiple qualitative data sets.Health expectations : an international journal of public participation in health care and health policy · 2017Article
- Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care.International journal of circumpolar health · 2015Article
- Patient factors associated with SSRI dose for depression treatment in general practice: a primary care cross sectional study.BMC family practice · 2014Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatient participation in primary care treatment decisions has been much debated. There has been little attention to patients' contributions to primary care consultations over a period of time, when consulting about depression and its treatment with antidepressants.
aimTo explore: (1) what issues remain unsaid during a primary care consultation for depression but are later raised by the patient as important during a research interview; (2) patients' reasons for non-disclosure; (3) whether unvoiced agendas are later voiced; and (4) the nature of the GP-patient relationship in which unvoiced agendas occur. DESIGN OF STUDY: Qualitative interview study.
settingPrimary health care.
methodPatients were recruited through six general practices in the south west of England. Qualitative interviews were carried out with 10 'pairs' of GPs and patients who presented with a new or first episode of moderate to severe depression and were prescribed antidepressants. Follow-up patient interviews were conducted at 3 and 6 months. Throughout the 6-month period, patients were invited to record subsequent consultations (with GPs' consent), using a patient-held tape recorder.
resultsTwenty-three unvoiced agendas were revealed, often within decision-making relationships that were viewed in positive terms by patients. Unvoiced agendas included: a preference for immediate treatment, a preference to increase dosage, and the return or worsening of suicidal thoughts. In some cases, patients were concerned that they were 'letting the GP down' by not being able to report feeling better.
conclusionUnvoiced agendas are not necessarily an indication that 'shared decision making' is absent but may in some cases represent patients' attempts to 'protect' their GPs.
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