Document Detail


Barriers to referral in patients with angina: qualitative study.
MedLine Citation:
PMID:  10445924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To explore barriers to patients being referred for possible revascularisation.
DESIGN: Qualitative study using semi-structured interviews.
PARTICIPANTS: 16 patients aged under 75 years with stable angina and their doctors.
SETTING: General practice in Toxteth, Liverpool.
RESULTS: Fear of both hospitals and medical tests was common and largely hidden from the doctors. Patients felt they were old, had low expectations of treatment, viewed angina as a chronic illness, and knew little about new developments in angina treatment. Patients and doctors had difficulty in recognising angina symptoms that were not textbook definitions amid multiple comorbidity. Patients saw doctors as busy and did not want to bother them with their condition. Cultural gaps and communication difficulties existed despite all but one patient having English as their first language.
CONCLUSIONS: Listening to patients is vital to address inequitable access to health services: how patients are treated by doctors today affects acceptability of referral tomorrow. Primary care groups in deprived areas should work with communities to address local fears. This will involve collaboration between primary, secondary, and tertiary care. Cultural gaps exist between patients and doctors in deprived areas, and diagnostic confusion can occur particularly in the presence of other psychological and physical morbidity. Adequate time and resources-for example, education for doctors and patients and provision of interpreters-need to be provided if inequitable access to revascularisation procedures is to be addressed.
Authors:
K Gardner; A Chapple
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  319     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-20     Completed Date:  1999-09-20     Revised Date:  2013-04-17    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  418-21     Citation Subset:  AIM; IM    
Affiliation:
Princes Park Health Centre, Liverpool L8 OSY. katy@papaya.demon.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / diagnosis,  therapy*
Attitude to Health
Culture
Family Practice
Great Britain
Health Services Accessibility*
Humans
Middle Aged
Physician-Patient Relations
Referral and Consultation / organization & administration*
Comments/Corrections
Comment In:
BMJ. 1999 Nov 6;319(7219):1266-7   [PMID:  10550104 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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