Factors associated with visits to general practitioners in patients with schizophrenia in Malaga

Abstract

BackgroundPatients with psychiatric disorders have more physical problems than other patients, so their follow-up by the general practitioner is particularly important for them.MethodsWe aimed to elaborate a multilevel explanatory model of general practitioner (GP) visits made by patients with schizophrenia and related disorders (SRD). An observational, cross-sectional study was conducted from January 1, 2008 to July 1, 2011, in the area of the Clinical Management Unit of Mental Health (CMU-MH) of the Regional Hospital of Malaga (Spain). The eligible population consisted of all patients with SRD in contact with a GP residing in the study area. Our dependent variable was total number GP visits. The independent variables were: 1) patient variables (sociodemographic and clinical variables); 2) primary care centre (PCC) variables. We performed descriptive analysis, bivariate analysis and multilevel regression.ResultsFour hundred ninety four patients were included. Mean annual number of GP visits was 4.1. Female sex, living in a socioeconomically deprived area, a diagnosis of schizoaffective disorder and contact with a GP who had a more active approach to mental health issues were associated with a higher number of visits whilst being single and good communication between the PCC and mental health teams were associated with a lower number of GP visits.ConclusionsNumber of GP visits was not just associated with patient factors, but also with organisational and the involvement of health professionals, for example GPs with an active approach to mental health issues.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0866-7) contains supplementary material, which is available to authorized users.

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

“…In a previous study carried out by our research group, we analysed the relationship between patients with SRD/PCC characteristics and the number of visits to GPs [22]. The novelty of the present study is in the association of characteristics of the GPs who treated these patients with the amount of contact with GPs, which led to important findings.…”

“…Of the patient sample included in Castillejos et al [22], only those patients who had information about their GP were included.…”

“…In addition, feeling unprepared, having low confidence, and a lack of resources to manage mental illness from GPs [19,20] could encourage GPs to transfer these patients to specialised care [21]. Both factors could explain the low contact of patients with SRDs with primary care services [16,21,22]. On the other hand, mental health professionals often do not feel confident in prescribing physical health medication [23].…”

“…Taking this into account and bearing in mind the important role of GPs as a main entry point into the healthcare system and as specialists in physical health problems, it is essential to study whether the characteristics of these professionals could influence the care of patients with SRDs. In a previous study, we analysed the association between patient factors and primary care centre (PCC) variables with the number of SRD patient visits to GPs [22], but we lacked an important link-the role of GP characteristics in the contact. In this study, we analysed the association of both the patients and PCC variables as well as GP variables with the number of SRD patient visits to GPs.…”

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

“…Of the patient sample included in Castillejos et al [22], only those patients who had information about their GP were included (N = 259). The sample included in Castillejos et al [22] consisted of patients with SRDs included in the RESMA (n = 1,663) [27]. The sample size was calculated to be representative of the patients of each PCC.…”