PT - JOURNAL ARTICLE AU - Emily Lyness AU - Jane Louise Vennik AU - Felicity L Bishop AU - Pranati Misurya AU - Jeremy Howick AU - Kirsten A Smith AU - Mohana Ratnapalan AU - Stephanie Hughes AU - Hajira Dambha-Miller AU - Jennifer Bostock AU - Leanne Morrison AU - Christian D Mallen AU - Lucy Yardley AU - Geraldine Leydon AU - Paul Little AU - Hazel Everitt TI - Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes AID - 10.3399/BJGPO.2021.0014 DP - 2021 May 05 TA - BJGP Open PG - BJGPO.2021.0014 4099 - http://bjgpopen.org/content/early/2021/05/04/BJGPO.2021.0014.short 4100 - http://bjgpopen.org/content/early/2021/05/04/BJGPO.2021.0014.full AB - Background Osteoarthritis (OA) causes pain and disability. An empathic optimistic consultation approach can improve patient quality of life, satisfaction with care, and reduce pain. However, expressing empathic optimism may be overlooked in busy primary care consultations and there is limited understanding of patients’ views about this approach.Aim To explore patients’ perspectives on clinician communication of empathy and optimism in primary care OA consultations.Design & setting Vignette study with qualitative semi-structured interviews. Purposefully sampled patients (n = 33) aged >45 years with hip or knee OA from GP practices in Wessex (Hampshire, Dorest, Wiltshire, and Somerset).Method Fifteen participants watched two filmed OA consultations with a GP, and 18 participants read two case vignettes. In both formats, one GP depicted an empathic optimistic approach and one GP had a ‘neutral’ approach. Semi-structured interviews were conducted with all participants and analysed using thematic analysis.Results Patients recognised that empathic communication enhanced interactions, helping to engender a sense of trust in their clinician. They felt it was acceptable for GPs to convey optimism only if it was realistic, personalised, and embedded within an empathic consultation. Discussing patients’ experiences and views with them, and conveying an accurate understanding of these experiences improves the credibility of optimistic messages.Conclusion Patients value communication with empathy and optimism, but it requires a fine balance to ensure messages remain realistic and trustworthy. Increased use of a realistic optimistic approach within an empathic consultation could enhance consultations for OA and other chronic conditions, and improve patient outcomes. Digital training to help GPs implement these findings is being developed.