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Title: Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI): a qualitative study
Speakers: Maureen Seguin and Laura Hall
Introduction
The doctor-patient relationship has acknowledged therapeutic power. Societal changes such as patient access to previously privileged health information via the internet and increasing emphasis on self-management are fundamentally altering the GP-patient relationship. Patients who 'go online' for health information may be reluctant to share this with their doctors. Similarly, many GPs report concerns about how best to respond when patients introduce such information in consultations. Much existing research relies on retroactive reports from patients and doctors following consultations, yet what people say they do differs from what they actually do.
Methods
Data are from multiple sources. We aim to collect 300 cases which consist of questionnaire data from patients to determine the help sought and information sources accessed prior to consultations, video-recorded consultations and semi-structured interviews with all 10 of the GPs involved in video recording consultations. We are also conducting interviews with up to 30 patients involved in the study. The questionnaires are analysed descriptively to provide contextual information. Conversation analysis is used to identify patterns of interaction and the consequences of what is said to better understand the use of the internet in consultations. The interviews with the GPs (n=10) and patients (n=30) after their consultations are being analysed thematically to illuminate the perceived barriers and facilitators to disclosing or promoting discussions of online health information in consultations.
Results
Analysis of data from consultations using conversation analysis indicates that patients can be seen to carefully select the best place in the consultation to make reference to prior use of the internet and often use phrases that minimise or downplay the internet as a source of information. Interactional difficulties occur when use of the internet is raised by patients in a place that disrupts the natural flow of the consultation. GPs use the internet in consultations to inform themselves and provide explanations to patients, provide printed information to patients and to signpost patients to information and self-help resources
Discussion
The work here provides an understanding of what is currently happening in relation to discussion, and use, of the internet in GP consultations. The findings will be used to identify strategies to aid both GPs and patients in the potentially interactionally-fraught area of discussion of the internet in consultations.