RT Journal Article
SR Electronic
T1 GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e646
OP e653
DO 10.3399/bjgp18X698405
VO 68
IS 674
A1 Charlotte Albury
A1 Elizabeth Stokoe
A1 Sue Ziebland
A1 Helena Webb
A1 Paul Aveyard
YR 2018
UL http://bjgp.org/content/68/674/e646.abstract
AB Background Guidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.Aim To examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and setting A mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.Method Conversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.Results Affirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.Conclusion When doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.