Exploring patients’ ideas, expectations, and concerns may reduce prescribing in primary care

Analysis of primary care consultations suggests that exploration of patients ideas, expectations, and concerns may be associated with reduced prescription for new medications.

This study aimed to determine whether exploring the combination of patients ideas, expectations, and concerns (ICE) in primary care consultations affected medication prescribing. It was carried out on a single day in 36 Belgian teaching GP practices: observers, who were trainee GPs, recorded reasons for a patient encounter, whether components of ICE were identified, and whether a prescription was produced.

A total of 613 consultations was observed, and one, two, or three of the ICE components were expressed in 38.5%, 24.4%, and 20.1% (n = 236, 150, 123) of contacts respectively. In 17% (104) none of the components was voiced. When the 350 new contacts were analysed, the presence vs. absence of concerns (OR 1.73; 95% CI, 1.03 to 2.9; p=0.037) and expectations (OR 2.0; 95% CI = 1.2 to 3.4; p=0.009) were associated with not prescribing new medicines.

The authors conclude that declaration of patient concerns and expectations was associated with a lower rate of new prescriptions. They therefore suggest that exploring these components may help reduce prescribing.

[Editor’s note: taken from abstract as full text not available.]