Clinical characteristics of persistent frequent attenders in primary care: case–control study
Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews wit...
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| Format: | Article |
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Oxford University Press
2015
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| Online Access: | https://eprints.nottingham.ac.uk/30459/ |
| _version_ | 1848793990168576000 |
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| author | Patel, Shireen Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Malins, Samuel Sampson, Christopher James Stubley, Michelle Morriss, Richard K. |
| author_facet | Patel, Shireen Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Malins, Samuel Sampson, Christopher James Stubley, Michelle Morriss, Richard K. |
| author_sort | Patel, Shireen |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status.
Objective. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary care, currently and over the preceding 2 years, with normal attenders (NAs) matched by age, gender and general practice.
Methods. Case–control study of 71 FAs (30 or more GP or practice nurse consultations in 2 years) and 71 NAs, drawn from five primary care practices, employing standardized psychiatric interview, quality of life, health anxiety and primary care electronic record review over the preceding 2 years.
Results. Compared to NAs, FAs were more likely to report a lower quality of life (P < 0.001), be unmarried (P = 0.03) and have no educational qualifications (P = 0.009) but did not differ in employment status. FAs experienced greater health anxiety (P < 0.001), morbid obesity (P = 0.02), pain (P < 0.001) and long-term pathological and ill-defined physical conditions (P < 0.001). FAs had more depression including dysthymia, anxiety and somatoform disorders (all P < 0.001).
Conclusions. Persistent frequent attendance in primary care was associated with poor quality of life and high clinical complexity characterized by diverse and often persistent physical and mental multimorbidity. A brokerage model with GPs working in close liaison with skilled psychological therapists is required to manage such persistent complexity. |
| first_indexed | 2025-11-14T19:09:04Z |
| format | Article |
| id | nottingham-30459 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:09:04Z |
| publishDate | 2015 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-304592020-05-04T17:20:07Z https://eprints.nottingham.ac.uk/30459/ Clinical characteristics of persistent frequent attenders in primary care: case–control study Patel, Shireen Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Malins, Samuel Sampson, Christopher James Stubley, Michelle Morriss, Richard K. Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status. Objective. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary care, currently and over the preceding 2 years, with normal attenders (NAs) matched by age, gender and general practice. Methods. Case–control study of 71 FAs (30 or more GP or practice nurse consultations in 2 years) and 71 NAs, drawn from five primary care practices, employing standardized psychiatric interview, quality of life, health anxiety and primary care electronic record review over the preceding 2 years. Results. Compared to NAs, FAs were more likely to report a lower quality of life (P < 0.001), be unmarried (P = 0.03) and have no educational qualifications (P = 0.009) but did not differ in employment status. FAs experienced greater health anxiety (P < 0.001), morbid obesity (P = 0.02), pain (P < 0.001) and long-term pathological and ill-defined physical conditions (P < 0.001). FAs had more depression including dysthymia, anxiety and somatoform disorders (all P < 0.001). Conclusions. Persistent frequent attendance in primary care was associated with poor quality of life and high clinical complexity characterized by diverse and often persistent physical and mental multimorbidity. A brokerage model with GPs working in close liaison with skilled psychological therapists is required to manage such persistent complexity. Oxford University Press 2015-10-08 Article NonPeerReviewed Patel, Shireen, Kai, Joe, Atha, Christopher, Avery, Anthony, Guo, Boliang, James, Marilyn, Malins, Samuel, Sampson, Christopher James, Stubley, Michelle and Morriss, Richard K. (2015) Clinical characteristics of persistent frequent attenders in primary care: case–control study. Family Practice . ISSN 1460-2229 (In Press) Medically Unexplained Symptoms Primary Care mental health Depression Mood Disorder Quality of Life Anxiety Anxiety Disorder Access to Care http://fampra.oxfordjournals.org/content/early/2015/10/07/fampra.cmv076 doi:10.1093/fampra/cmv076 doi:10.1093/fampra/cmv076 |
| spellingShingle | Medically Unexplained Symptoms Primary Care mental health Depression Mood Disorder Quality of Life Anxiety Anxiety Disorder Access to Care Patel, Shireen Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Malins, Samuel Sampson, Christopher James Stubley, Michelle Morriss, Richard K. Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title | Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title_full | Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title_fullStr | Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title_full_unstemmed | Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title_short | Clinical characteristics of persistent frequent attenders in primary care: case–control study |
| title_sort | clinical characteristics of persistent frequent attenders in primary care: case–control study |
| topic | Medically Unexplained Symptoms Primary Care mental health Depression Mood Disorder Quality of Life Anxiety Anxiety Disorder Access to Care |
| url | https://eprints.nottingham.ac.uk/30459/ https://eprints.nottingham.ac.uk/30459/ https://eprints.nottingham.ac.uk/30459/ |