Peter J. Edwards (United Kingdom)
University of Bristol Centre for Academic Primary CareAuthor Of 1 Presentation
COMPARISON OF SPOKEN AND DOCUMENTED SAFETY-NETTING ADVICE IN ADULT UK GP CONSULTATIONS AND AN EXPLORATION OF FACTORS AFFECTING DOCUMENTATION
Abstract
Abstract Body
Background and purpose: Safety-netting advice (SNA) is ‘information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.’1 We currently know very little about how UK general practitioners (GPs) document this information and what factors might influence whether SNA is recorded in the medical records or not.
Methods: Coding of existing dataset of video / audio recorded consultations and medical records for 295 adults with 516 problems seeing 23 UK GPs. Descriptive statistics and logistic regression models were used to test associations.
Results: SNA was given to patients in two-thirds of consultations (192/295) with regard to almost half of all problems discussed (242/516). SNA was documented in one-third (94/295) of consultations and for one-fifth of problems (105/506). Individual GP practice varied from no documentation of SNA they had given to 86.7%. GPs more frequently documented SNA they had given for problems that were first presentations (p=0.045), when only one problem was discussed in the consultation (p=0.044), and when the GP had given specific, rather than generic SNA (p=0.007). In consultations where more than one problem was discussed, the frequency of SNA delivered and documented decreased the later a problem was assessed by the GP (p=0.011 and p=0.022, respectively).
Conclusion: GPs often do not document SNA they have given which may have serious medico-legal implications. The frequency of SNA is influenced by problem, GP and consultation factors.
1. https://doi.org/10.3399/bjgp19X706589
Presenter of 1 Presentation
COMPARISON OF SPOKEN AND DOCUMENTED SAFETY-NETTING ADVICE IN ADULT UK GP CONSULTATIONS AND AN EXPLORATION OF FACTORS AFFECTING DOCUMENTATION
Abstract
Abstract Body
Background and purpose: Safety-netting advice (SNA) is ‘information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.’1 We currently know very little about how UK general practitioners (GPs) document this information and what factors might influence whether SNA is recorded in the medical records or not.
Methods: Coding of existing dataset of video / audio recorded consultations and medical records for 295 adults with 516 problems seeing 23 UK GPs. Descriptive statistics and logistic regression models were used to test associations.
Results: SNA was given to patients in two-thirds of consultations (192/295) with regard to almost half of all problems discussed (242/516). SNA was documented in one-third (94/295) of consultations and for one-fifth of problems (105/506). Individual GP practice varied from no documentation of SNA they had given to 86.7%. GPs more frequently documented SNA they had given for problems that were first presentations (p=0.045), when only one problem was discussed in the consultation (p=0.044), and when the GP had given specific, rather than generic SNA (p=0.007). In consultations where more than one problem was discussed, the frequency of SNA delivered and documented decreased the later a problem was assessed by the GP (p=0.011 and p=0.022, respectively).
Conclusion: GPs often do not document SNA they have given which may have serious medico-legal implications. The frequency of SNA is influenced by problem, GP and consultation factors.
1. https://doi.org/10.3399/bjgp19X706589