The expression of aversion to medicines in general practice consultations

Nicky Britten, Fiona Stevenson, Joseph Gafaranga, Christine Barry, Colin Bradley

Research output: Contribution to journalArticlepeer-review

Abstract

Although the relevance of patientsâ?? views about medicines for their medicine taking behaviour is now well established, little is known about the ways in which these views are discussed in primary care consultations. In particular, many studies have demonstrated patientsâ?? aversion to medicines. This paper examines the form that aversion talk takes in the consultation and how doctors respond to patientsâ?? expression of aversion to medicines. It is based on a dataset of 35 case studies of general practice consultations in England. In interviews with researchers, aversion to medicines was expressed in 34 of the 35 cases. In consultations with doctors, aversion was expressed in 10 cases. The interactional dimension of aversion talk in consultations was analysed using Conversation Analysis, and two general patterns were identified. Aversion could be used as an interactional resource, or it could be a topic in its own right. If used as an interactional resource, no real discussion of patientsâ?? views of medicines took place. When aversion was a conversational topic in its own right, two situations were observed. Firstly, the doctor elicited patientsâ?? views directly. Secondly, patients initiated aversive talk using a range of indirect strategies to do so. Even when patients managed to express their aversion to medicines, doctors did not engage them in any real discussion of their views. A scheme of interpretation is suggested to explain these findings. In this scheme patients perceive medicines to be an extension of the doctor and to be beneficial. In this view it is right for doctors to prescribe medicines and for patients to take medicines. The results of this paper suggest that using aversion as an interactional resource might be the only safe way for patients to express their aversion without seeming to breach the social contract.
Original languageEnglish
Pages (from-to)1495-1503
Number of pages9
JournalSocial Science and Medicine
Volume59
Issue number7
DOIs
Publication statusPublished - Oct 2004

Keywords

  • Communication
  • Prescribing
  • Primary care
  • Patientsâ?? views
  • UK

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