Association of Common Mental Disorders and Quality of Life with the Frequency of Attendance in Slovenian Family Medicine Practices: Longitudinal Study

Abstract

BackgroundMost research on frequent attendance has been cross-sectional and restricted to one year attendance rates. A few longitudinal studies suggest that frequent attendance is self-limiting. Frequent attenders are more likely to have social and psychiatric problems, medically unexplained physical symptoms, chronic somatic diseases (especially diabetes) and are prescribed more psychotropic medication and analgesics.Research QuestionTo describe the attendance rates in a longitudinal study and to test if depression, panic syndrome, other anxiety syndrome, alcohol misuse and general quality of life are associated with frequent attendance in next two consecutive years.Methods1118 consecutive family practice attendees, aged 18 to 75 years from randomly selected family medicine practices were recruited at baseline and followed up at 12 and 24 months. We identified frequent attenders in the top 10 centile within one year. Using a multivariate model, we ascertained if presence of common mental disorders and quality of life assessed at baseline in 2003 predict frequent attendance in 2004 and 2005.Results40% of frequent attenders continue to be frequent attenders in the following year and 20% of the frequent attenders were so for the 24 month period. Lower physical scores on the SF-12 questionnaire were strongly associated with future frequent attendance at 12 and 24 months. There was a trend for people with greater than elementary school education to be less likely to become frequent attenders at both 12 and 24 months. For other variables these effects were less consistent. Presence of major depression, panic syndrome, other anxiety syndrome and alcohol misuse were not predictive of frequent attendance in the following two years.ConclusionLow physical quality of life is strongly predictive of higher frequent attendance and similar finding was observed for people with lower educational level but further confirmatory research is required to establish this association.

Psychosocial characteristics and affective symptomatology associated with patient self‐initiated consultations in Spanish general practice

“…Lastly, users with high self‐initiated consultation rates showed a higher probability of suffering from subclinical affective symptomatology. Our study supported previous results that showed a higher degree of psychological distress (Norton et al., 2012; Vedsted et al., 2001) or anxiety/depression (Kersnik, Svab, & Vegnuti, 2001; Rifel et al., 2013; Sheehan et al., 2003; Smits et al., 2014) among frequent attenders.…”

Frequent attenders in primary health care: A concept analysis

“…Usually, consultations with frequent attenders decreased after one year. Overall, 40% of frequent attenders continued to be frequent attenders the following year and 20% continued for two years (Rifel et al, 2013).…”

“…Men's consultations increased at an even older age. In addition to older age, frequent attenders were also characterised by lower levels of education (Jyväsjärvi et al, 2001;Kersnik et al, 2001;Little et al, 2001;Vedsted and Olesen, 2005;Al-Kandari et al, 2008;Robles et al, 2009;Koskela et al, 2010;Gili et al, 2011;Norton et al, 2012;Gomes et al, 2013;Rifel et al, 2013;Kaattari et al, 2015;Patel et al, 2015;Jørgensen et al, 2016).…”

“…Term that describe frequent attenders Other search terms that describe primary health care "frequent attend*" AND "primary health care" (MH "Primary Health Care") or "general practise (MH "General Practise") or "family practise (MH "Family Practise" or "physicians, family" (MH "Physicians, family")  Lower perceived quality of life (Kersnik et al, 2001;van Steenkiste et al, 2010;Rifel et al, 2013;Kaattari et al, 2015;Patel et al, 2015) Frequent visits to a primary health care provider  ≥1 consultation a month during six months (Menchetti et al, 2006)  ≥3 consultations in 12 months (Buja et al, 2015)  ≥5 consultations in 12 months (Little et al, 2001;Andersson et al, 2004)  ≥7 consultations in 12 months (den Boer-Wolters et al, 2009;Diaz et al, 2014;Nyman and Jäppinen, 2015)  ≥8 consultations in 12 months (Jyväsjärvi et al, 2001;Kersnik et al, 2001;Koskela et al, 2010;Kaattari et al, 2015;Dinkel et al, 2016)  ≥10 consultations in 12 months (Neal et al, 2001)  ≥12 consultations in 12 months (Scaife et al, 2000;Carney et al, 2001;Al-Kandari et al, 2008;Robles et al, 2009;Gili et al, 2011)  ≥13 consultations in 12 months (Stewart and O'Dowd, 2002)  ≥24 consultations in 12 months (Hauswaldt et al, 2013)  ≥15 consultations in 30 months (Savageau et al, 2006)  ≥15 consultations in 36 months (Schilte et al, 2001;Glaser et al, 2006)  ≥30 consultations in 24 months (Patel et al, 2015)  The top 3 % of attenders in 12 months (Howe et al, 2002;Pickvance et al, 2004;Smits et al, 2008)  The top 3 % of attenders in 41 months (Neal et al, 2000a)  The top 10% of attenders in 6 months…”

Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP)

“…More specifically, most publications in the field of frequent attendance are restricted to a cross-sectional design [1,11]. There is a lack of studies analyzing the phenomenon of frequent attendance using longitudinal data [8,12,13]. Using longitudinal data is important to tackle the issue of unobserved heterogeneity (e.g., genetic disposition) and to gain insights into intraindividual changes over time (e.g., changes within individuals over time from non-frequent attendance to frequent attendance).…”