Solicitations in GP, nurse and pharmacist prescriber consultations: an observational study.
BACKGROUND
The opening solicitation is a key element of the primary care consultation as it enables patients to express their ideas, concerns and expectations that can lead to improved patient outcomes. However, in practice, this may not always occur. With nurses and pharmacists now able to prescribe, this research explored the opening solicitation in a multi-professional context.


OBJECTIVE
To compare the nature, frequency and response to opening solicitations used in consultations with nurse prescribers (NPs), pharmacist prescribers (PPs) and GPs.


METHODS
An observational study using audio-recordings of NP, PP and GP patient consultations in 36 primary care practices in southern England. Between 7-13 prescriber-patient consultations were recorded per prescriber. A standardized pro forma based upon previous research was used to assess recordings.


RESULTS
Five hundred and thirty-three patient consultations (213 GPs, 209 NPs, 111 PPs) were audio-recorded with 51 prescribers. Across the prescribing groups, pharmacists asked fewer opening solicitations, while GPs used more open questions than NPs and PPs. The mean number of patient agenda items was 1.3 with more items in GP consultations. Patients completed their opening agenda in 20% of consultations, which was unaffected by professional seen. Redirection of the patient's agenda occurred at 24 seconds (mean).


CONCLUSIONS
All prescribers should be encouraged to use more open questions and ask multiple solicitations throughout the consultation. This is likely to result in greater expression of patients' concerns and improved patient outcomes.
Department of Pharmacy and Pharmacology, University of Bath, Bath.
Marjorie C
MC
Weiss
Jo
J
Platt
Ruth
R
Riley
Gordon
G
Taylor
Susan
S
Horrocks
Andrea
A
Taylor
D000328:Adult; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
Consultation; doctor–patient relationships; health communication; nurse practitioners; pharmacists; primary health care.