Effect of patient completed agenda forms and doctors' education about the agenda on the outcome of consultations: randomised controlled trial

Objective: To assess the effect of patient completed agenda forms for the consultation and doctors’ education on identifying patients’ agendas on the outcome of consultations. Design: Randomised controlled trial. Setting: General practices in Leicestershire and Nottinghamshire, United Kingdom. Participants: 46 general practitioners and 976 patients. Interventions: Education for general practitioners, with an embedded clustered randomised controlled trial of a patient agenda form. Main outcome measures: Number of problems identified, time required to manage each problem, duration of consultations, number of problems raised after the doctor considered the consultation finished (“by the way” questions), and patient satisfaction. Results: Data were available from 45 doctors (98%) and 857 patients (88%). The number of problems identified in each consultation increased by 0.2 (95% confidence interval 0.1 to 0.4) with the agenda form, by 0.3 (0.1 to 0.6) with education, and by 0.5 (0.3 to 0.7) with both interventions. The time required to manage each problem was not affected. The duration of consultations with the agenda form was increased by 0.9 minutes (0.3 to1.5 minutes) and with the combined intervention by 1.9 minutes (1.0 to 2.8 minutes). Patient satisfaction with the depth of the doctor-patient relationship was increased with the agenda form. The occurrence of “by the way” presentations did not change. Conclusion: A patient completed agenda form before the consultation or general practitioner education about the agenda form, or both, enabled the identification of more problems in consultations even though consultations were longer.