Britten2004

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Britten2004
BibType ARTICLE
Key Britten2004
Author(s) Nicky Britten, Fiona Stevenson, Joseph Gafaranga, Christine Barry, Colin Bradley
Title The Expression of Aversion to Medicines in General Practice Consultations
Editor(s)
Tag(s) Medical EMCA, Conversation Analysis, Prescribing, Primary Care, General Practice Consultations
Publisher
Year 2004
Language
City
Month
Journal Social Science & Medicine
Volume 59
Number 7
Pages 1495–1503
URL Link
DOI 10.1016/j.socscimed.2004.01.019
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
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Abstract

Although the relevance of patients’ views about medicines for their medicine taking behaviour is now well established, little is known about the ways in which these views are discussed in primary care consultations. In particular, many studies have demonstrated patients’ aversion to medicines. This paper examines the form that aversion talk takes in the consultation and how doctors respond to patients’ expression of aversion to medicines. It is based on a dataset of 35 case studies of general practice consultations in England. In interviews with researchers, aversion to medicines was expressed in 34 of the 35 cases. In consultations with doctors, aversion was expressed in 10 cases. The interactional dimension of aversion talk in consultations was analysed using Conversation Analysis, and two general patterns were identified. Aversion could be used as an interactional resource, or it could be a topic in its own right. If used as an interactional resource, no real discussion of patients’ views of medicines took place. When aversion was a conversational topic in its own right, two situations were observed. Firstly, the doctor elicited patients’ views directly. Secondly, patients initiated aversive talk using a range of indirect strategies to do so. Even when patients managed to express their aversion to medicines, doctors did not engage them in any real discussion of their views. A scheme of interpretation is suggested to explain these findings. In this scheme patients perceive medicines to be an extension of the doctor and to be beneficial. In this view it is right for doctors to prescribe medicines and for patients to take medicines. The results of this paper suggest that using aversion as an interactional resource might be the only safe way for patients to express their aversion without seeming to breach the social contract.

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