Patients’ expectations and experiences with primary care management: A qualitative study

Context: Shoulder pain management is challenging for primary care clinicians considering that 40% of affected individuals remain symptomatic one year after initial consultation. Developing tailored knowledge translation interventions founded on evidence-based recommendations while also considering patients’ expectations could improve primary care management of adults living with shoulder pain.

Objective: The aim of this qualitative study is to explore patients’ expectations and experiences of their primary care management for shoulder pain.

Study design and Analysis: Using a qualitative study design, we conducted virtual individual interviews. Interviews were recorded, transcribed into verbatims, and an inductive thematic analysis was performed.

Setting: Various primary care settings in the Province of Quebec, Canada.

Population studied: Adults who consulted a primary care clinician (physician or physiotherapist) in the past year for shoulder pain.

Instrument: A semi-structured interview guide included questions related to patients’ history of shoulder pain and related disability, motivation to consult, expectations about medical management and rehabilitation and experience with care consultations and provider interactions.

Outcome measures: Using deductive thematic analysis, emergent themes related to participants’ expectations and experiences of primary care consultations for shoulder pain were identified.

Results: We interviewed 13 participants. Four overarching themes were identified: 1) I can’t sleep because of my shoulder; 2) I need to know what is happening with my shoulder; 3) But& we need to really see what is going on to help me!; and 4) Please take some time with me so I can understand what to do!. More specifically, several participants reported waiting until they experienced high levels of pain before consulting since they had low expectations about the ability of their family physician to help them. Although some participants felt that their physician took the time to listen to their concerns, many were dissatisfied with the initial evaluation of their condition, or the explanation or education provided.

Conclusions: One unexpected finding that emerged from this study was the delay between the onset of shoulder pain and when patients decided to consult their primary care clinician. Several participants reported that their expectations were not met, especially when it came to explanations or education provided.