RT Journal Article SR Electronic T1 Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: a qualitative interview study using vignettes JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP BJGPO.2021.0014 DO 10.3399/BJGPO.2021.0014 VO 5 IS 3 A1 Emily Lyness A1 Jane Louise Vennik A1 Felicity L Bishop A1 Pranati Misurya A1 Jeremy Howick A1 Kirsten A Smith A1 Mohana Ratnapalan A1 Stephanie Hughes A1 Hajira Dambha-Miller A1 Jennifer Bostock A1 Leanne Morrison A1 Christian D Mallen A1 Lucy Yardley A1 Geraldine Leydon A1 Paul Little A1 Hazel Everitt YR 2021 UL http://bjgpopen.org/content/5/3/BJGPO.2021.0014.abstract 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.