Group medical consultation for osteoporosis: a prospective pilot study of patient experience in Canadian tertiary care.

BACKGROUND: Delivery of patient-centred care is limited by physician time. Group medical consultations may save physician time without compromising patient experience. AIM: To assess patient experience and specialist physician time commitment in a group consultation for osteoporosis. DESIGN AND
SETTING: Prospective pilot study at a tertiary osteoporosis centre in Canada between May 2016 and June 2019.
METHOD: The authors evaluated women referred for osteoporosis who chose a 2-hour group consultation instead of a one-to-one consultation. Group consultations were led by an osteoporosis nurse and specialist physician, and consisted of individualised fracture risk assessment and education regarding osteoporosis therapies, followed by a decision-making exercise to choose a treatment plan. Patients then followed up with their GPs to implement this plan. Patient experience was assessed via a questionnaire immediately and 3 months post-consultation, at which time GP satisfaction and patient treatment status were also surveyed.
RESULTS: Of 560 referrals received, 18 patients declined osteoporosis specialist assessment, 54 could not be contacted, 303 attended a one-to- one consultation, and 185 attended a group consultation. Mean participant age was 62.8 years (standard deviation [SD] 5.8) and the Fracture Risk Assessment Tool (FRAX) 10-year osteoporotic fracture risk was 13.0 (SD 7.0)%. Immediately post-consultation, 104 (97.2%) patients were satisfied and 102 (95.3%) felt included in decision making. Satisfaction was reported by 95/99 (96.0%) patients and 27/36 (75.0%) GPs. Treatment plans had been enacted by 90 (90.1%) patients. For a matched number of individual consultations, each group session conferred a specialist physician time savings of 5.5 hours.
CONCLUSION: Group consultations represent a satisfactory and time-efficient alternative to one-to-one consultations for select patients with osteoporosis. © British Journal of General Practice 2020.