title: Sub-optimal patient and physician communication in primary care consultations: its relation to severe and difficult asthma.
abstract: BACKGROUND
  Asthma control can be influenced by a range of non-medical issues, including psychosocial factors. Little is known about the views of patients, particularly those with severe and/or difficult asthma, towards their asthma control and their asthma-related primary care consultations.
  
  
  OBJECTIVE
  To explore patients' experiences of their asthma and primary care asthma consultations in order to identify target areas for intervention.
  
  
  METHODS
  This was a qualitative study of 14 asthma patients based in grounded theory. Questions were asked about: asthma understanding; control issues; and interactions with primary care health professionals. Data were analysed using the constant comparative method and framework approach.
  
  
  RESULTS
  Participants with severe and/or difficult asthma normalised control issues, were reluctant to discuss non-medical factors with healthcare professionals (HCPs), reported poorer communication with HCPs, and were reluctant to raise relevant but non-medical factors in the consultation.
  
  
  CONCLUSIONS
  Our data identifies that patients, particularly those with severe and/or difficult asthma and poor control, underplay symptoms and do not discuss non-medical factors which may impact on asthma control in primary care consultations. This poor communication is associated with patients underestimating disease severity and/or what could be achieved in terms of disease control. Training HCPs in the use of patient-centred communication skills may optimise asthma management in primary care.
authors.affiliation: Department of General Practice and Primary Care, University of Aberdeen, UK. m.moffat@abdn.ac.uk
authors.forename: Mandy
authors.initials: M
authors.lastname: Moffat
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cleland
authors.forename: Thys
authors.initials: T
authors.lastname: van der Molen
authors.forename: David
authors.initials: D
authors.lastname: Price
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000523:psychology / Q000628:therapy*; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research