Responsibility of follow-up regarding medical recommendations in primary care and challenging patients: The perspective of doctors, nurses, pharmacists, and administrative staff

M. Khazen*, L. Shalev, A. Golan-Cohen, A. J. Rose

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study examines the way healthcare staff describe challenging patients and perceive responsibility for follow-up of patients with chronic conditions. Methods: Interviews were conducted with 46 healthcare staff (15 primary care physicians/12 nurses/15 administrative staff/4 pharmacists) at 12 clinics in Israel. They were audiotaped, transcribed, and thematically analyzed using Atlas qualitative data analysis software. Results: Participants defined patients as “challenging” either because they are less likely to follow medical recommendations or are felt to overconsume care. Staff believed that patients did not follow medical recommendations because they were indifferent, unaware, in denial about deteriorating medical condition, or fear of the unknown. Participants generally perceived a shared responsibility for follow-up between the staff and the patient. Staff who endorsed closer relationships with staff members expressed empathy toward challenging patients and felt responsible for follow-up. Conclusions: Healthcare staff perceive themselves as partially responsible for helping patients follow up with medical recommendations. Cohesive staff relationships may promote higher levels of empathy toward challenging patients and may contribute to helping patients follow up with recommended care. Practice implications To improve follow-up with medical recommendations, there is a need to develop and test interventions to promote more cohesive ties among clinic staff.

Original languageEnglish
Article number108456
JournalPatient Education and Counseling
Volume130
DOIs
StatePublished - Jan 2025

Bibliographical note

Publisher Copyright:
© 2024 Elsevier B.V.

Keywords

  • Challenging patients
  • Difficult patients
  • Empathy toward patients
  • Healthcare staff collaboration
  • Patients with chronic conditions
  • Primary care settings
  • Responsibility of follow-up

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