Preferences of patients for patient centred approach to consultation in primary care: observational study.
OBJECTIVE
To identify patient's preferences for patient centred consultation in general practice.


METHODS
Questionnaire study.


METHODS
Consecutive patients in the waiting room of three doctors' surgeries.


METHODS
Key domains of patient centredness from the patient perspective. Predictors of preferences for patient centredness, a prescription, and examination.


RESULTS
865 patients participated: 824 (95%) returned the pre-consultation questionnaire and were similar in demographic characteristic to national samples. Factor analysis identified three domains of patient preferences: communication (agreed with by 88-99%), partnership (77-87%), and health promotion (85-89%). Fewer wanted an examination (63%), and only a quarter wanted a prescription. As desire for a prescription was modestly associated with desire for good communication (odds ratio 1.20; 95% confidence interval 0.85 to 1.69), partnership (1.46; 1.01 to 2.09), and health promotion (1.61; 1.12 to 2.31) this study may have underestimated preferences for patient centredness compared with populations with stronger preferences for a prescription. Patients who strongly wanted good communication were more likely to feel unwell (very, moderately, and slightly unwell; odds ratios 1, 0.56, 0.39 respectively, z trend P<0.001), be high attenders (1.70; 1.18 to 2.44), and have no paid work (1.84; 1.21 to 2.79). Strongly wanting partnership was also related to feeling unwell, worrying about the problem, high attendance, and no paid work; and health promotion to high attendance and worry.


CONCLUSIONS
Patients in primary care strongly want a patient centred approach, with communication, partnership, and health promotion. Doctors should be sensitive to patients who have a strong preference for patient centredness-those vulnerable either psychosocially or because they are feeling unwell.
Primary Medical Care Group, Community Clinical Sciences Division, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK. psl3@soton.ac.uk
P
P
Little
H
H
Everitt
I
I
Williamson
G
G
Warner
M
M
Moore
C
C
Gould
K
K
Ferrier
S
S
Payne
D000293:Adolescent; D000328:Adult; D011307:Drug Prescriptions; D004739:England; D005163:Factor Analysis, Statistical; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires