Influencia del acompañante en las consultas de Atención Primaria sobre las habilidades en comunicación y el tiempo de entrevista

OBJETIVES: To know the influence of the companion in triadic clinical encounter on the quality of doctor–patient communication and the duration of the interview. DESIGN: Cross-sectional descriptive study. LOCATION: 10 Primary Care Centers. PARTICIPANTS: Resident doctors of Family and Community Medicine. INTERVENTIONS: Peer review of video recordings of clinical demand consultations. MAIN MEASUREMENTS: CICAA-2 questionnaire to assess communication skills (improvable, acceptable or adequate); age and sex, reasons for consultation and duration of the interview. Bivariate and multivariate analyses. Ethical authorization, oral informed consent and custody of the video recordings. RESULTS: 73 RD (53.8% women, 32.9 ± 7.7 years) participated with 260 interviews (60.3% women and 2.1 ± 1.0 clinical demands). 27.7% of consultations with a companion (female sex 65.3%). The mean duration of the interviews was 8.5 ± 4.0 min. Clinical encounters lasted longer when a companion attended (2.7 ± 0.5 min more; p < .001 Student t) and with a greater number of clinical demands (40% with ≥3 reasons, p = 0.048 X(2)). The mean value of the total score of the CICAA-2 scale (46.9 ± 16.5; difference 4.6 ± 2.3) and Task 2 (39.3 ± 15.8 with difference 4.4 ± 2.2) were higher when companion was present (p < .05 Student t). The model obtained with logistic regression shows a longer duration of the consultation with a companion (OR 1.2; CI [1.1–1.3]) and possibly a better score in Task 2 communication skills (OR 1.02; CI [0.99–1.1]). CONCLUSIONS: Triadic communications challenge the clinician's communication skills, improving their abilities to identify and understand patient problems, albeit at the cost of a greater investment of time.