The first consultation for low mood in general practice: what do patients find helpful?

Author:

Morgan Ian1ORCID,Dowrick Chris2ORCID,Macdonald Sara3ORCID,Wilkes Scott4ORCID,Watson Stuart5ORCID

Affiliation:

1. Newburn Surgery , Newcastle-upon-Tyne NE15 8LX , United Kingdom

2. Department of Health Services Research, Institute of Population Health Sciences, Waterhouse Building, University of Liverpool , Liverpool L69 3BX , United Kingdom

3. General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow , Horselethill Road, Glasgow G12 9LX , United Kingdom

4. Faculty of Health Sciences and Wellbeing, Sciences Complex, City Campus, University of Sunderland , Chester Road, Sunderland SR1 3SD , United Kingdom

5. Academic Psychiatry and Regional Affective Disorders Service, Wolfson Research Centre, Campus for Ageing and Vitality, University of Newcastle , Newcastle-upon-Tyne NE4 5PL , United Kingdom

Abstract

AbstractBackgroundRecent evidence suggests that the first consultation with a general practitioner (GP) for symptoms of depression may be more than just a vehicle for assessment and management planning (as current guidelines imply).ObjectivesTo identify what patients find helpful, or otherwise, in their first consultation for low mood with a GP.MethodsA cross-sectional questionnaire and interview study of patients with low mood who had recently consulted their GP, in the North of England. Patients were asked to complete a questionnaire regarding the consultation, and a Patient Health Questionnaire-9 (PHQ-9), within 2 weeks. They were also invited to take part in a face–face interview with a researcher. Both sources of data were subjected to qualitative thematic analysis.ResultsThirty-seven questionnaires were returned; 5 interviews took place. The majority of participants felt better after consulting a GP for the first time for low mood. The factors most commonly cited as helpful were “being listened to” and “understanding or empathy from the GP.” Others included “admitting the problem,” “being reassured of normality,” and “being provided with optimism or hope for change.” The most commonly reported difficulty was the patients’ struggle to express themselves. Patients often felt that GP follow-up was inadequate.ConclusionsThese results suggest that the therapeutic benefit of the GP consultation is under-recognized in current guidelines. The results of our study will provide crucial information as to how such consultations can be tailored to improve patient satisfaction.

Funder

Helen Lester Fellowship

Scientific Foundation Board

Royal College of General Practitioners

IJM

Publisher

Oxford University Press (OUP)

Subject

Family Practice

Reference21 articles.

1. A review of the current guidelines for depression treatment;Gelenberg;J Clin Psychiatry,2010

2. An evidence-based first consultation for depression: nine key messages;Arroll;Br J Gen Pract,2018

3. Optimizing the care of patients with depression in primary care: the views of general practitioners;Railton;Health Soc Care Community,2000

4. Communicative skills of general practitioners augment the effectiveness of guideline-based depression treatment;Van Os;J Affect Disord,2005

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