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Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain

OBJECTIVES: To estimate the frequency of patient-perceived potentially harmful problems occurring in primary care. To describe the type of problem, patient predictors of perceiving a problem, the primary care service involved, how the problem was discussed and patient suggestions as to how the probl...

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Autores principales: Stocks, Susan Jill, Donnelly, Ailsa, Esmail, Aneez, Beresford, Joanne, Luty, Sarah, Deacon, Richard, Danczak, Avril, Mann, Nicola, Townsend, David, Ashley, James, Gamble, Carolyn, Bowie, Paul, Campbell, Stephen M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009615/
https://www.ncbi.nlm.nih.gov/pubmed/29899057
http://dx.doi.org/10.1136/bmjopen-2017-020952
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author Stocks, Susan Jill
Donnelly, Ailsa
Esmail, Aneez
Beresford, Joanne
Luty, Sarah
Deacon, Richard
Danczak, Avril
Mann, Nicola
Townsend, David
Ashley, James
Gamble, Carolyn
Bowie, Paul
Campbell, Stephen M
author_facet Stocks, Susan Jill
Donnelly, Ailsa
Esmail, Aneez
Beresford, Joanne
Luty, Sarah
Deacon, Richard
Danczak, Avril
Mann, Nicola
Townsend, David
Ashley, James
Gamble, Carolyn
Bowie, Paul
Campbell, Stephen M
author_sort Stocks, Susan Jill
collection PubMed
description OBJECTIVES: To estimate the frequency of patient-perceived potentially harmful problems occurring in primary care. To describe the type of problem, patient predictors of perceiving a problem, the primary care service involved, how the problem was discussed and patient suggestions as to how the problem might have been prevented. To describe clinician/public opinions regarding the likelihood that the patient-described scenario is potentially harmful. DESIGN: Population-level survey. SETTING: Great Britain. PARTICIPANTS: A nationally representative sample of 3975 members of the public aged ≥15 years interviewed during April 2016. MAIN OUTCOME MEASURES: Counts of patient-perceived potentially harmful problems in the last 12 months, descriptions of patient-described scenarios and review by clinicians/members of the public. RESULTS: 3975 of 3996 participants in a nationally representative survey completed the relevant questions (99.5%). 300 (7.6%; 95% CI 6.7% to 8.4%) of respondents reported experiencing a potentially harmful preventable problem in primary care during the past 12 months and 145 (48%) discussed their concerns within primary care. This did not vary with age, gender or type of service used. A substantial minority (30%) of the patient-perceived problems occurred outside general practice, particularly the dental surgery, walk in clinic, out of hours care and pharmacy. Patients perceiving a potentially harmful preventable problem were eight times more likely to have ‘no confidence and trust in primary care’ compared with ‘yes, definitely’ (OR 7.9; 95% CI 5.9 to 10.7) but those who discussed their perceived-problem appeared to maintain higher trust and confidence. Generally, clinicians ranked the patient-described scenarios as unlikely to be potentially harmful. CONCLUSIONS: This study highlights the importance of actively soliciting patient’s views about preventable harm in primary care as patients frequently perceive potentially harmful preventable problems and make useful suggestions for their prevention. Such engagement may also help to improve confidence and trust in primary care.
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spelling pubmed-60096152018-06-25 Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain Stocks, Susan Jill Donnelly, Ailsa Esmail, Aneez Beresford, Joanne Luty, Sarah Deacon, Richard Danczak, Avril Mann, Nicola Townsend, David Ashley, James Gamble, Carolyn Bowie, Paul Campbell, Stephen M BMJ Open General practice / Family practice OBJECTIVES: To estimate the frequency of patient-perceived potentially harmful problems occurring in primary care. To describe the type of problem, patient predictors of perceiving a problem, the primary care service involved, how the problem was discussed and patient suggestions as to how the problem might have been prevented. To describe clinician/public opinions regarding the likelihood that the patient-described scenario is potentially harmful. DESIGN: Population-level survey. SETTING: Great Britain. PARTICIPANTS: A nationally representative sample of 3975 members of the public aged ≥15 years interviewed during April 2016. MAIN OUTCOME MEASURES: Counts of patient-perceived potentially harmful problems in the last 12 months, descriptions of patient-described scenarios and review by clinicians/members of the public. RESULTS: 3975 of 3996 participants in a nationally representative survey completed the relevant questions (99.5%). 300 (7.6%; 95% CI 6.7% to 8.4%) of respondents reported experiencing a potentially harmful preventable problem in primary care during the past 12 months and 145 (48%) discussed their concerns within primary care. This did not vary with age, gender or type of service used. A substantial minority (30%) of the patient-perceived problems occurred outside general practice, particularly the dental surgery, walk in clinic, out of hours care and pharmacy. Patients perceiving a potentially harmful preventable problem were eight times more likely to have ‘no confidence and trust in primary care’ compared with ‘yes, definitely’ (OR 7.9; 95% CI 5.9 to 10.7) but those who discussed their perceived-problem appeared to maintain higher trust and confidence. Generally, clinicians ranked the patient-described scenarios as unlikely to be potentially harmful. CONCLUSIONS: This study highlights the importance of actively soliciting patient’s views about preventable harm in primary care as patients frequently perceive potentially harmful preventable problems and make useful suggestions for their prevention. Such engagement may also help to improve confidence and trust in primary care. BMJ Publishing Group 2018-06-13 /pmc/articles/PMC6009615/ /pubmed/29899057 http://dx.doi.org/10.1136/bmjopen-2017-020952 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle General practice / Family practice
Stocks, Susan Jill
Donnelly, Ailsa
Esmail, Aneez
Beresford, Joanne
Luty, Sarah
Deacon, Richard
Danczak, Avril
Mann, Nicola
Townsend, David
Ashley, James
Gamble, Carolyn
Bowie, Paul
Campbell, Stephen M
Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title_full Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title_fullStr Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title_full_unstemmed Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title_short Frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in Great Britain
title_sort frequency and nature of potentially harmful preventable problems in primary care from the patient’s perspective with clinician review: a population-level survey in great britain
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009615/
https://www.ncbi.nlm.nih.gov/pubmed/29899057
http://dx.doi.org/10.1136/bmjopen-2017-020952
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