Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study
Background: Most frequent attendance in primary care is temporary. Long-term frequent attendance may be suitable for psychological intervention to address health management and service use. Aim: To explore the feasibility and acceptability of cognitive-behaviour therapy (CBT) for long-term frequ...
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| Format: | Article |
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Royal College of General Practitioners
2016
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| Online Access: | https://eprints.nottingham.ac.uk/33706/ |
| _version_ | 1848794685865197568 |
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| author | Malins, Samuel Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Patel, Shireen Sampson, Christopher Stubley, Michelle Morriss, Richard K. |
| author_facet | Malins, Samuel Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Patel, Shireen Sampson, Christopher Stubley, Michelle Morriss, Richard K. |
| author_sort | Malins, Samuel |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Most frequent attendance in primary care is temporary. Long-term frequent attendance may be suitable for psychological intervention to address health management and service use.
Aim: To explore the feasibility and acceptability of cognitive-behaviour therapy (CBT) for long-term frequent attendance in primary care and obtain preliminary evidence regarding clinical and cost-effectiveness.
Design and Setting: A CBT case series was carried out in five GP practices.
Method: Frequent attenders (FAs) were identified from case notes and invited by their practice for assessment, then offered CBT. Feasibility and acceptability were assessed by CBT session attendance and thematic analysis of semi-structured questionnaires. Clinical and cost effectiveness was assessed by primary care use and clinically important change on a range of health and quality of life instruments.
Results: Of 462 FAs invited to interview, 87 (19%) consented to assessment. Thirty-two (7%) undertook CBT over median three months. Twenty-four (75%) attended > 6 sessions. Eighteen FAs (86%, n=21) reported overall satisfaction with treatment. Patients reported valuing listening without judgement alongside support to develop coping strategies. Thirteen (55%, n=24) achieved clinically important improvement on the SF-36 Mental-Component Scale at six month follow-up and improved quality of life, but no improvement on other outcomes. Primary care use reduced from median eight contacts in three months at baseline (n=32) to three contacts in three months at one year (n=18).
Conclusion: CBT appears feasible and acceptable to a sub-set of long-term FAs in primary care who halved their primary care use. With improved recruitment strategies, this approach might contribute to decreasing GP workload and merits larger-scale evaluation. |
| first_indexed | 2025-11-14T19:20:08Z |
| format | Article |
| id | nottingham-33706 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:20:08Z |
| publishDate | 2016 |
| publisher | Royal College of General Practitioners |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-337062020-05-04T18:14:38Z https://eprints.nottingham.ac.uk/33706/ Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study Malins, Samuel Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Patel, Shireen Sampson, Christopher Stubley, Michelle Morriss, Richard K. Background: Most frequent attendance in primary care is temporary. Long-term frequent attendance may be suitable for psychological intervention to address health management and service use. Aim: To explore the feasibility and acceptability of cognitive-behaviour therapy (CBT) for long-term frequent attendance in primary care and obtain preliminary evidence regarding clinical and cost-effectiveness. Design and Setting: A CBT case series was carried out in five GP practices. Method: Frequent attenders (FAs) were identified from case notes and invited by their practice for assessment, then offered CBT. Feasibility and acceptability were assessed by CBT session attendance and thematic analysis of semi-structured questionnaires. Clinical and cost effectiveness was assessed by primary care use and clinically important change on a range of health and quality of life instruments. Results: Of 462 FAs invited to interview, 87 (19%) consented to assessment. Thirty-two (7%) undertook CBT over median three months. Twenty-four (75%) attended > 6 sessions. Eighteen FAs (86%, n=21) reported overall satisfaction with treatment. Patients reported valuing listening without judgement alongside support to develop coping strategies. Thirteen (55%, n=24) achieved clinically important improvement on the SF-36 Mental-Component Scale at six month follow-up and improved quality of life, but no improvement on other outcomes. Primary care use reduced from median eight contacts in three months at baseline (n=32) to three contacts in three months at one year (n=18). Conclusion: CBT appears feasible and acceptable to a sub-set of long-term FAs in primary care who halved their primary care use. With improved recruitment strategies, this approach might contribute to decreasing GP workload and merits larger-scale evaluation. Royal College of General Practitioners 2016-10-31 Article PeerReviewed Malins, Samuel, Kai, Joe, Atha, Christopher, Avery, Anthony, Guo, Boliang, James, Marilyn, Patel, Shireen, Sampson, Christopher, Stubley, Michelle and Morriss, Richard K. (2016) Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study. British Journal of General Practice, 66 (651). e729-e736. ISSN 1478-5242 Frequent attendance; primary health care; cognitive behaviour therapy; health anxiety; medically unexplained symptoms; quality of life; costs http://bjgp.org/content/66/651/e729 doi:10.3399/bjgp16X686569 doi:10.3399/bjgp16X686569 |
| spellingShingle | Frequent attendance; primary health care; cognitive behaviour therapy; health anxiety; medically unexplained symptoms; quality of life; costs Malins, Samuel Kai, Joe Atha, Christopher Avery, Anthony Guo, Boliang James, Marilyn Patel, Shireen Sampson, Christopher Stubley, Michelle Morriss, Richard K. Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title | Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title_full | Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title_fullStr | Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title_full_unstemmed | Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title_short | Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| title_sort | cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study |
| topic | Frequent attendance; primary health care; cognitive behaviour therapy; health anxiety; medically unexplained symptoms; quality of life; costs |
| url | https://eprints.nottingham.ac.uk/33706/ https://eprints.nottingham.ac.uk/33706/ https://eprints.nottingham.ac.uk/33706/ |