Barriers to referral in patients with angina: qualitative study   Commentary: Generalisability and validity in qualitative research

Patients in deprived areas with stable angina perceive themselves as “old” at a young age, and expectations of treatment are limited, so care of patients in inner city primary care may not be the same as those in a textbook.

Abstract

Listening to patients is vital to address inequitable access to health services: how patients are treated by doctors today affects acceptability of referral tomorrow. Primary care groups in deprived areas should work with communities to address local fears. This will involve collaboration between primary, secondary, and tertiary care. Cultural gaps exist between patients and doctors in deprived areas, and diagnostic confusion can occur particularly in the presence of other psychological and physical morbidity. Adequate time and resources-for example, education for doctors and patients and provision of interpreters-need to be provided if inequitable access to revascularisation procedures is to be addressed.