A comparison of GP, pharmacist and nurse prescriber responses to patients' emotional cues and concerns in primary care consultations

Objective: Recognising patients' cues and concerns is an important part of patient centred care. With nurses and pharmacists now able to prescribe in the UK, this study compared the frequency, nature, and professionals' responses to patient cues and concerns in consultations with GPs, nurse prescribers and pharmacist prescribers. Methods: Audio-recording and analysis of primary care consultations in England between patients and nurse prescribers, pharmacist prescribers and GPs. Recordings were coded for the number of cues and concerns raised, cue or concern type and whether responded to positively or missed. Results: A total of 528 consultations were audio-recorded with 51 professionals: 20 GPs, 19 nurse prescribers and 12 pharmacist prescribers. Overall there were 3.5 cues or concerns per consultation, with no difference between prescriber groups. Pharmacist prescribers responded positively to 81% of patient's cues and concerns with nurse prescribers responding positively to 72% and GPs 53% (PhP v NP: U = 7453, z = -2.1, p = 0.04; PhP v GP: U = 5463, z = -5.9, p < 0.0001; NP v GP: U = 12,070, z = -4.9, p < 0.0001). Conclusion: This evidence suggests that pharmacists and nurses are responding supportively to patients' cues and concerns. Practice implications: The findings support the importance of patient-centredness in training new prescribers and their potential in providing public health roles. (C) 2012 Elsevier Ireland Ltd. All rights reserved.