Non-disclosure of symptoms in primary care: an observational study

Zoe Paskins, Tom Sanders, Peter Croft, Jackie Green, Robert McKinley, Andrew Hassell

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Symptoms form a major component of patient agendas, with the need for an explanation of symptoms being a prominent reason for consultation.

Objectives: To estimate the prevalence of different symptoms pre-consultation; to investigate whether intention to mention a symptom in the consultation varied between patients and across symptoms; and to determine how patients’ intended agendas for mentioning symptoms compared with what was discussed.

Method: We video-recorded consultations of an unselected sample of people aged 45 and over consulting their GP in 7 different practices in UK primary care. A preconsultation questionnaire recorded the patient’s agenda for the consultation, current symptoms and symptoms the patient intended to discuss with their GP. The video recorded consultation was viewed and all patient agendas and ‘symptoms with intention to discuss’ were compared with the actual topics of discussion.

Results: 190 patients participated. 81 (42.6 were female and the mean age was 68 (range 46-93). Joint pain was the most commonly reported symptom. 139 (81.8% of those reporting symptoms) patients reported intention to discuss a symptom. In 43 (22.6 consultations, 67 symptoms (27.2 where an intention to discuss had been expressed, remained undisclosed. Tiredness and sleeping difficulty were more likely to be withheld than other symptoms after an intention to discuss had been expressed. Of the more physically located symptoms, joint pain was the most likely to remain undisclosed.

Conclusion: This study suggests that the extent of symptom non-disclosure varies between patients, physicians and symptoms. Further work needs to explore the consequences of non-disclosure.
Original languageEnglish
Pages (from-to)706-711
Number of pages6
JournalFamily Practice
Issue number6
Publication statusPublished - 7 Apr 2018


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