Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI): a qualitative study

Conference:

SAPC ASM 2018 - London

Talk Code:

1E.6

Presenter:

Laura Hall

Co-authors:

Maureen Seguin, Helen Atherton, Rebecca Barnes, Trish Greenhalgh, Geraldine Leydon, Elizabeth Murray, Catherine Pope, Sue Ziebland & Fiona Stevenson

Author institutions:

Laura Hall (UCL) Maureen Seguin (UCL), Helen Atherton (University of Warwick), Rebecca Barnes (University of Bristol), Trish Greenhalgh (University of Oxford), Geraldine Leydon (University of Southampton), Elizabeth Murray (UCL), Catherine Pope (University of Southampton), Sue Ziebland (University of Oxford) & Fiona Stevenson (UCL)

Problem

Patients are increasingly expected to manage their health outside of medical consultations. The internet has become an important source of health-care information and advice. Despite recent calls for patients to ‘go online’ prior to consultations, patients may be reluctant to share what they find with their doctors. Moreover, many GPs report concerns about how best to respond when patients introduce information from the internet in consultations. It is also unclear if, and how, GPs promote or warn against patient use of the internet or indeed if, and how, they use it themselves in consultations. Previous studies on the interaction between internet-informed patients and their doctors have tended to rely on patient or GP accounts, yet we know that what people say they do differs from what they actually do. By video-recording GP consultations, this study will provide an additional perspective on existing evidence relating to patterns of communication between doctors and patients.

Approach

This presentation draws on 200 video-recorded consultations with associated questionnaire data on prior internet use. Conversation analysis has been used to examine patterns of interaction during consultations, and a descriptive analysis of the questionnaire data provides valuable contextual information.

Findings

Drawing on work on the interactional order of consultations, analysis of when and how patients raise information they obtained from the internet during their consultations demonstrates how problems occur when information from the internet is introduced in a place that makes it difficult for the GP to respond.

Consequences

This paper demonstrates the value of employing theory concerned with the interactional order of consultations to understanding everyday interactions about the internet in GP consultations.

Submitted by:

Laura Hall

Funding acknowledgement:

The HaRI study is funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.