The content and conduct of GP consultations for dermatology problems: a cross-sectional study

Emma F Le Roux, Peter J Edwards, Emily J Sanderson, Rebecca K Barnes, Matthew J Ridd*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

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Abstract

Background: Skin complaints are common in primary care and poor outcomes in long-term conditions are often due to low treatment adherence. Shared decision making (SDM) and self-management support may help, yet there is little understanding of patient involvement or support provided by GPs.

Aim: To describe the content of primary care consultations for skin problems including SDM practice, delivery of self-management advice and follow-up.

Design and Setting: Cross-sectional study of video-recorded UK adult GP consultations and linked data.

Method: A coding tool was developed and applied to all consultations with skin problems. SDM was assessed using the observer OPTION5 scale.

Results: 45/318 consultations (14.2%) had one or more skin problems, which were discussed alongside other problems in 71.1% of consultations. Of the 100 different problems discussed, 51 were dermatological. The mean amount of time spent on skin problems was 4 minutes 16 seconds. Medication was recommended for 66.7% of skin problems with low SDM (mean OPTION5 score 10.7). Self-management advice was given for 47.1% of skin problems (verbal only). Most skin problems (84.3%) were not referred to secondary care. 32.6% of skin problems not referred were seen again in primary care within 12 weeks, of which 35.7% were unplanned.

Conclusion: Skin problems are usually presented alongside other complaints and result in a medication recommendation. SDM was uncommon and self-management advice not consistently given, with reattendance for the same problem common. GPs’ training should reflect how frequently skin problems are seen and seek to improve patient involvement in decision making/support self-management.
Original languageEnglish
Article numberbjgp20X712577
Number of pages20
JournalBritish Journal of General Practice
DOIs
Publication statusPublished - 7 Sep 2020

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