Improving the GP-patient relationship: barriers and facilitators

GP Patients Relationship Header

What are the barriers that prevent or limit the development of a good relationship between GPs and patients? What are the facilitators? 

This blog explores what the Verve Journal Club (details at the bottom of this blog) found when we discussed a systematic review published in January 2020, and investigates this fascinating topic.

PAPER REVIEWED:

Barriers and facilitators to GP–patient communication about emotional concerns in the UK primary care: a systematic review’.

View the full paper here.

The paper looks into GP-Patient relationships and their importance in treatment, considering it as a 2-way process rather than the responsibility of the GP only. The review also looks into patients’ emotional concerns and mental health, looking at how GPs can manage this. 

The review was broken into the two key sections of barriers and facilitators:

SECTION 1 – BARRIERS

EMOTIONAL CONCERNS

Patients who experienced emotional concerns and mental health issues found it difficult to disclose them to their GPs.

Journal Club discussion points: 

Mental health is not always understood among the public. Obsolete stigmas and low education might result in patients feeling “guilty” about their feelings. 

But are GPs aware of this? Have they received the training required to carry appropriate conversations with patients and recognise the signs of emotional discomfort in their body language?

TENSION BETWEEN MEDICAL AND SOCIAL EXPLANATORY MODELS

Patients who linked their issues to difficult life circumstances emphasised self-management as a way to cope with their situation, as opposed to taking medicines. 

Journal Club discussion points

What’s the difference between self-management and self-care? Self-management can be described as a condition to deal with, possibly in the long-term. On the other hand, self-care is self-treatment/proactive care, and also a preventative action (e.g. healthy diet).  

UNSPOKEN ASSUMPTIONS ABOUT AGENCY

GPs reported frustrations with patients due to a lack of communication.

Journal Club discussion points

Patients need to feel comfortable and know their GP well in order to open up. Restricted timings with the GP might be a significant limiting factor in preventing a fruitful 2-way communication. 

SECTION 2 – FACILITATORS 

A HUMAN CONNECTION 

A shared understanding was supported by open psychological questioning. 

Journal Club discussion points: 

GPs should be trained to understand unspoken communication, such as body language. This might trigger the right questions if the GP notices a patient is anxious but won’t explicitly talk about it. 

PROVIDING INFORMATION FACILITATES INVOLVEMENT 

Involving patients in treatment decisions was empowering, improved adherence and helped improve symptoms. 

Journal Club discussion points

The increased adoption of digital consultations and the difficulty to see a GP in person might lead to a loss of human connection which is so important for mental health issues.  

JOURNAL CLUB OVERALL VIEW:

Whilst the article focuses on mental health issues as the basis, we found that its findings could be equally applicable to other treatment areas. 

The paper gave some good insights and learnings into good GP-patient communication and relationships, but it raised as many questions as it answered. It would be great to see some more work and research done in this area but at least this review helps put it higher in the agenda. 

WHAT IS THE VERVE JOURNAL CLUB?

Our monthly journal club is a great opportunity for us to keep up with the latest research in different therapy areas. It allows us to combine our HCP work with our passion for advances and knowledge in healthcare. 

The club is a chance for the team to come together to evaluate and discuss articles within pharmaceutical literature within a social environment.

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