The role of a companion attending consultations with the patient. A systematic review.

OBJECTIVE: To review the literature pertaining to communication patterns and dynamics of doctor-patient-companion or 'triadic' medical encounters as identified in both quantitative and qualitative studies. To consider the role of an attending companion in specialist groups using the context of chronic pain as a group example.

METHODS: Studies were identified via database searches and reference lists. The eligibility of studies and data extracted were cross-checked with inclusion and exclusion criteria.

RESULTS: Of the 1094 titles identified, 20 studies were included for review. Tables were created for patient settings and study outcomes. Results indicated that companions frequently attended consultations, usually with a relative such as their spouse or adult child and were found to influence communicative processes in the encounter. This influence could either be negative (limiting the exchange of information, particularly relating to sensitive topics) or positive (improvement of self-care management), with study outcomes varying widely. The chronic pain subgroup has not yet been researched in the context of triadic consultations.

CONCLUSION: Triadic communication can be advantageous in medical encounters; however, as differences exist depending on the individual medical setting, caution should be asserted in generalising findings.