GPs' recognition of, and response to, influences on patients' medicine taking: the implications for communication.
BACKGROUND
Research evidence suggests that patients' beliefs about medicines influence medicine taking. Therefore, it is important that GPs are able to both identify and take account of such beliefs in the consultation.


OBJECTIVE
The purpose of this study was to explore GPs' awareness of asthma patients' beliefs about medicine, and of the ways in which friends and family, television programmes and the Campaign for Asthma may influence these beliefs. We also wanted to consider how GPs believe they would feel, and their likely behaviour, when a patient refers to these influences in the consultation.


METHODS
Four events, drawn from 17 semi-structured interviews previously conducted with patients recently prescribed oral steroids (prednisolone), were used to compose a narrative account of a hypothetical patient's behaviour. The narrative described a series of scenarios to which GPs were asked to respond. It was sent to all GPs in Derbyshire (n = 476).


RESULTS
The response rate was 69%. Half judged that the scenarios which presented the patients' beliefs about medicine, the influence of friends and family and the television were not 'realistic'. GPs also reported feeling more 'supportive' and 'sympathetic' towards the Campaign for Asthma as a source of patient information than they were towards opinions based on advice given by patients' family and friends.


CONCLUSIONS
Developing 'common ground' in the consultation will be problematic if GPs are not aware of, and sympathetic towards, the ways in which patients use information from a range of sources to formulate beliefs that then affect their medicine-taking behaviour. GPs should be encouraged to open up their discussions with patients so as to encourage the development of a partnership in which each party is aware of, and respects, the other's point of view.
Stevenson
F A
FA
Department of General Practice and Primary Care, Guy's King's and St Thomas' School of Medicine, 5 Lambeth Walk, London SE11 6SP, UK.
Gerrett
D
D
Rivers
P
P
Wallace
G
G
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D005190:Family / Q000523:psychology; D005194:Family Practice / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010353:Patient Education as Topic / Q000379:methods*; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D011239:Prednisolone / Q000627:therapeutic use*; D012657:Self-Help Groups; D011795:Surveys and Questionnaires; D013690:Television
D000893:Anti-Inflammatory Agents; D011239:Prednisolone