Frequent attenders with medically unexplained symptoms: service use and costs in secondary care

Abstract

Frequent attenders with medically unexplained symptoms account for levels of service use and expenditure that are comparable with other frequent attenders, but the use and cost of medical investigations in this group are significantly greater.

Frequent attendance in family practice and common mental disorders in an open access health care system

“…Few studies report on the association between FA in primary care and other areas of care [12,17,23]. Our findings indicate as elsewhere that FA behavior is not restricted to family practice as this behavior extends into secondary care and contact with both medical and paramedical services, suggesting unmet need at both the primary and secondary care level.…”

“…Higher rates of FA are found in association with mental illness [11,[14][15][16][17][18][19], the likelihood of FA increasing with anxiety disorder by a factor of 1.14 in a multi-adjusted model [19]. FAs also have higher rates of depressive symptoms [15,16,20,21], as well as somatoform symptoms or disorders [20][21][22][23].…”

Medically unexplained symptoms and the disease label

“…Yet, studies propose that anywhere from 10 to 35 per cent of primary consultations fail to alleviate the presenting complaint (Peveler et al, 1997;Feder et al, 2001;Sharpe and Carson, 2001;Reid et al, 2002;Carson et al, 2003).…”

Untitled

“…Sykdomsårsaken er ukjent, og det er vanskelig å finne fram til en tradisjonell medisinsk diagnose. De 'ubestemte' plagene -i engelskspråklig liEeratur omtalt som 'medically unexplained physical symptoms' (Reid, Wessely et al 2002) -er tilstander, som preges av kronisk lidelse og funksjonshemning. Plagene kan ha ulike medisinske betegnelser som fibromyalgi eller andre former for kroniske muskelsmerter, det kroniske utmaEelsessyndromet, vedvarende bekkenløsningsplager, whiplash eller nakkeslengsskade, irritabel tarm, kroniske underlivssmerter, kjeveledssyndrom, multippel kjemisk intoleranse.…”

“…Plagene kan ha ulike medisinske betegnelser som fibromyalgi eller andre former for kroniske muskelsmerter, det kroniske utmaEelsessyndromet, vedvarende bekkenløsningsplager, whiplash eller nakkeslengsskade, irritabel tarm, kroniske underlivssmerter, kjeveledssyndrom, multippel kjemisk intoleranse. Pasienter med 'ubestemte' helseplager står for en betydelig andel av konsultasjonene hos den praktiserende lege (Burton 2003) og i spesialisthelsetjenesten (Reid, Wessely et al 2002).…”