Do GPs and patients have differing views about the value of managing anxiety in primary care? A qualitative study

Research output: Contribution to conferenceConference Abstract

Abstract

Problem
Anxiety disorders are common, with a 40% increase in generalised anxiety disorder reported in the general population between 2007 and 2014. GP recording of anxiety disorders, however, has decreased between 1998 and 2008. It is not clear why there has been a decrease of GPs’ recording of anxiety, when rates in
the general population have increased. Could it be due to GPs being reluctant to record anxiety and if so, what might the implications of this be for patients?
The aim of this study was to understand patients’ and GPs’ views about recording of anxiety in primary care.
Approach
In-depth qualitative interviews were conducted with 20 patients and 15 GPs, purposively sampled from GP practices in the South West of England. Interviews
were held either in person or by telephone. A topic guide was used to ensure consistency across the interviews. The interviews were audio-recorded,
transcribed verbatim and analysed thematically.
Findings
GPs described that they felt management of symptoms was more important than giving a diagnosis of anxiety. They reported preferring to use symptom
codes rather than diagnostic codes in order to avoid assigning patients potentially stigmatising labels. In addition, they felt diagnostic codes encouraged some
patients to adopt a ‘sick-role’ or not help themselves. GPs explained that, when coding, they tended to reactivate previously used codes where possible, as
this was easier and ensured continuity of codes within practices. The decision to use a diagnostic code depended on severity and chronicity of symptoms,
and ‘anxiety state’ was mentioned as the code most often used. Some GPs reported that it was the role of a psychiatrist (not a GP) to diagnose a ‘disorder’. In
contrast, patients commented that receiving a diagnosis, and how the GP communicated this, was just as important as the management of symptoms.
Patients reported that understanding their diagnosis was beneficial in terms of acceptance and readiness to engage with treatment. They also stated that nonspecific codes such as ‘anxiousness’ or ‘anxiety state’ were unhelpful, and contributed to them not fully understanding their mental health.
Consequences
Whilst GPs appear reluctant to diagnose anxiety, patients think doing so would improve patient-practitioner communication, patients’ understanding of their symptoms and condition, and would lead to more effective management of anxiety in primary care.
Original languageEnglish
DOIs
Publication statusPublished - 13 Jul 2020
EventSociety for Academic Primary Care: Annual Scientific Meeting -
Duration: 15 Jul 202017 Jul 2020

Conference

ConferenceSociety for Academic Primary Care: Annual Scientific Meeting
Period15/07/2017/07/20

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