BACKGROUND: Eliciting patients' Ideas, Concerns, Expectations, and whether a problem has an Effect on their life (ICEE), is a widely recommended communication technique. However, it is not known how frequently ICEE components are raised in UK GP consultations. AIM: Assess the frequency of ICEE in routine GP consultations with adult patients and explore variables associated with ICEE. DESIGN AND SETTING: Secondary analysis of face-to-face video-recorded GP consultations archive. METHOD: Observational coding of 92 consultations. Associations were assessed using binomial and ordered logistic regression. RESULTS: Most consultations included at least one ICEE component (90.2%). The most common ICEE component per consultation was patient ideas (79.3%), followed by concerns (55.4%), expectations (51.1%) and then effects on life (42.4%). For all ICEE components, patients more commonly initiated the ICEE dialogue and in only three consultations (3.3%) GPs directly asked patients about their expectations.Problems that were acute (OR 2.98, 95% confidence interval [CI]=1.36-6.53, P=0.007) or assessed by GPs ≥50 years (OR 2.10, CI =1.07-4.13, P=0.030) were associated with more ICEE components. Problems assessed later in the consultation (OR 0.60 per problem order increase, CI =0.41-0.87, P=0.007), by patients ≥75 years (OR 0.40, CI =0.16-0.98, P=0.046) and from the most deprived cohort were associated with fewer ICEE components (OR 0.39, CI =0.17-0.92, P=0.032). Patient ideas were associated with more patients being 'very satisfied' post-consultation (OR 10.74, CI =1.60-72.0, P=0.014) and the opposite was true of concerns (OR 0.14, CI =0.02-0.86, P=0.034). CONCLUSION: ICEE components were associated with patient satisfaction and demographic variables. Further research is required to assess if the way ICEE are communicated affects these associations and other potential confounders.
Consultation skills, Family medicine, Patient perspectives