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Acceptability of the BATHE technique amongst GPs and frequently attending patients in primary care: a nested qualitative study

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Acceptability of the BATHE technique amongst GPs and frequently attending patients in primary care : a nested qualitative study. / Thomas, Clare; Cramer, Helen; Jackson, Sue; Kessler, David; Metcalfe, Chris; Record, Charlie; Barnes, Rebecca K.

In: BMC Family Practice, Vol. 20, 121 (2019), 03.09.2019.

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@article{7b9aff2b7ac6494699c5660deabda866,
title = "Acceptability of the BATHE technique amongst GPs and frequently attending patients in primary care: a nested qualitative study",
abstract = "Background: BATHE is a brief psychosocial intervention designed for physician use in patient consultations. The technique has gained some international recognition, but there is currently limited research evidence to demonstrate its acceptability and benefits to patient care. We conducted a pilot cluster randomised controlled trial and feasibility study to explore the use of BATHE as a key component of a person-focused intervention to improve the care of frequent attending patients in UK primary care. Methods: A nested qualitative interview study conducted within a pilot trial. The trial took place in six general practices in the South West of England. Eligible patients had been identified as being in the top 3{\%} of attenders in the previous 12 months. General practitioners (GPs) were trained to use BATHE during a one-hour initial training session, and two top-up trainings which included feedback on implementation fidelity. GPs were asked to use BATHE with their study patients for a period of 12 months. 34 GPs were trained and documented using BATHE in a total of 577 consultations with eligible patients during the intervention period. At the end of the intervention period, GPs and study patients from the intervention practices were invited to take part in an interview. Interviews were semi-structured, audio-recorded and transcribed. Thematic analysis was used. Results: Eleven GPs and 16 patients took part in post-intervention interviews. Benefits of using BATHE included making consultations more person-centred, challenging assumptions that the GP knew what was going on for the patient and their main concerns, and supporting self-management. Difficulties reported included changing existing consultation habits, identifying appropriate consultations in which to use BATHE, and organisational constraints. Conclusions: The study suggests that using BATHE is both acceptable and beneficial but also highlighted some of the difficulties GPs had incorporating BATHE into routine practice. Strategies to reduce these difficulties are needed before the extent of the potential benefits of BATHE can be fully assessed.Trial Registration: ISRCTN62939408 Prospectively registered on 24/06/2015",
keywords = "Primary Care, Person-centred care, BATHE, Frequent attenders, Qualitative methods",
author = "Clare Thomas and Helen Cramer and Sue Jackson and David Kessler and Chris Metcalfe and Charlie Record and Barnes, {Rebecca K.}",
year = "2019",
month = "9",
day = "3",
doi = "10.1186/s12875-019-1011-y",
language = "English",
volume = "20",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central",

}

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TY - JOUR

T1 - Acceptability of the BATHE technique amongst GPs and frequently attending patients in primary care

T2 - a nested qualitative study

AU - Thomas, Clare

AU - Cramer, Helen

AU - Jackson, Sue

AU - Kessler, David

AU - Metcalfe, Chris

AU - Record, Charlie

AU - Barnes, Rebecca K.

PY - 2019/9/3

Y1 - 2019/9/3

N2 - Background: BATHE is a brief psychosocial intervention designed for physician use in patient consultations. The technique has gained some international recognition, but there is currently limited research evidence to demonstrate its acceptability and benefits to patient care. We conducted a pilot cluster randomised controlled trial and feasibility study to explore the use of BATHE as a key component of a person-focused intervention to improve the care of frequent attending patients in UK primary care. Methods: A nested qualitative interview study conducted within a pilot trial. The trial took place in six general practices in the South West of England. Eligible patients had been identified as being in the top 3% of attenders in the previous 12 months. General practitioners (GPs) were trained to use BATHE during a one-hour initial training session, and two top-up trainings which included feedback on implementation fidelity. GPs were asked to use BATHE with their study patients for a period of 12 months. 34 GPs were trained and documented using BATHE in a total of 577 consultations with eligible patients during the intervention period. At the end of the intervention period, GPs and study patients from the intervention practices were invited to take part in an interview. Interviews were semi-structured, audio-recorded and transcribed. Thematic analysis was used. Results: Eleven GPs and 16 patients took part in post-intervention interviews. Benefits of using BATHE included making consultations more person-centred, challenging assumptions that the GP knew what was going on for the patient and their main concerns, and supporting self-management. Difficulties reported included changing existing consultation habits, identifying appropriate consultations in which to use BATHE, and organisational constraints. Conclusions: The study suggests that using BATHE is both acceptable and beneficial but also highlighted some of the difficulties GPs had incorporating BATHE into routine practice. Strategies to reduce these difficulties are needed before the extent of the potential benefits of BATHE can be fully assessed.Trial Registration: ISRCTN62939408 Prospectively registered on 24/06/2015

AB - Background: BATHE is a brief psychosocial intervention designed for physician use in patient consultations. The technique has gained some international recognition, but there is currently limited research evidence to demonstrate its acceptability and benefits to patient care. We conducted a pilot cluster randomised controlled trial and feasibility study to explore the use of BATHE as a key component of a person-focused intervention to improve the care of frequent attending patients in UK primary care. Methods: A nested qualitative interview study conducted within a pilot trial. The trial took place in six general practices in the South West of England. Eligible patients had been identified as being in the top 3% of attenders in the previous 12 months. General practitioners (GPs) were trained to use BATHE during a one-hour initial training session, and two top-up trainings which included feedback on implementation fidelity. GPs were asked to use BATHE with their study patients for a period of 12 months. 34 GPs were trained and documented using BATHE in a total of 577 consultations with eligible patients during the intervention period. At the end of the intervention period, GPs and study patients from the intervention practices were invited to take part in an interview. Interviews were semi-structured, audio-recorded and transcribed. Thematic analysis was used. Results: Eleven GPs and 16 patients took part in post-intervention interviews. Benefits of using BATHE included making consultations more person-centred, challenging assumptions that the GP knew what was going on for the patient and their main concerns, and supporting self-management. Difficulties reported included changing existing consultation habits, identifying appropriate consultations in which to use BATHE, and organisational constraints. Conclusions: The study suggests that using BATHE is both acceptable and beneficial but also highlighted some of the difficulties GPs had incorporating BATHE into routine practice. Strategies to reduce these difficulties are needed before the extent of the potential benefits of BATHE can be fully assessed.Trial Registration: ISRCTN62939408 Prospectively registered on 24/06/2015

KW - Primary Care

KW - Person-centred care

KW - BATHE

KW - Frequent attenders

KW - Qualitative methods

UR - http://www.scopus.com/inward/record.url?scp=85071771729&partnerID=8YFLogxK

U2 - 10.1186/s12875-019-1011-y

DO - 10.1186/s12875-019-1011-y

M3 - Article

C2 - 31481017

AN - SCOPUS:85071771729

VL - 20

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

M1 - 121 (2019)

ER -