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Safety-netting in routine primary care consultations: an observational study using video-recorded UK consultations

Research output: Contribution to journalArticle

Original languageEnglish
Article numberbjgp19X706601
Number of pages9
JournalBritish Journal of General Practice
DOIs
DateAccepted/In press - 2 Jul 2019
DatePublished (current) - 18 Nov 2019

Abstract

Background Safety-netting advice is information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.

Aim To assess when and how safety-netting advice is delivered in routine GP consultations.

Design and setting This was an observational study using 318 recorded GP consultations with adult patients in the UK.

Method A safety-netting coding tool was applied to all consultations. Logistic regression for the presence or absence of safety-netting advice was compared between patient, clinician, and problem variables.

Results A total of 390 episodes of safety-netting advice were observed in 205/318 (64.5%) consultations for 257/555 (46.3%) problems. Most advice was initiated by the GP (94.9%) and delivered in the treatment planning (52.1%) or closing (31.5%) consultation phases. Specific advice was delivered in almost half (47.2%) of episodes. Safety-netting advice was more likely to be present for problems that were acute (odds ratio [OR] 2.18, 95% confidence interval [CI] = 1.30 to 3.64), assessed first in the consultation (OR 2.94, 95% CI = 1.85 to 4.68) or assessed by GPs aged ≤49 years (OR 2.56, 95% CI = 1.45 to 4.51). Safety-netting advice was documented for only 109/242 (45.0%) problems.

Conclusion GPs appear to commonly give safety-netting advice, but the contingencies or actions required on the patient’s part may not always be specific or documented. The likelihood of safety-netting advice being delivered may vary according to characteristics of the problem or the GP. How to assess safety-netting outcomes in terms of patient benefits and harms does warrant further exploration.

    Research areas

  • health communication, patient safety, primary care, safety netting, video-recording

Documents

Documents

  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Royal College of General Practitioners at https://bjgp.org/content/early/2019/11/18/bjgp19X706601. Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 425 KB, PDF document

    Embargo ends: 18/11/20

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