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Frequent attenders at a primary care clinic: Occasional or regular abusers?

Published online by Cambridge University Press:  16 April 2020

A. Ascari
Affiliation:
Unità Operativa di Psichiatria Ospedaliero-Universitaria Modena Centro, Università di Modena e Reggio Emilia, Parma, Italy
S. Ferrari
Affiliation:
Unità Operativa di Psichiatria Ospedaliero-Universitaria Modena Centro, Università di Modena e Reggio Emilia, Parma, Italy
M. Andreoli
Affiliation:
MMG Distretto di Sassuolo, Modena, Italy
M. Peggi
Affiliation:
Facoltà di Psichiatria, Università di Parma, Parma, Italy
M. Rigatelli
Affiliation:
Unità Operativa di Psichiatria Ospedaliero-Universitaria Modena Centro, Università di Modena e Reggio Emilia, Parma, Italy

Abstract

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Background

Frequent attendance in general practice is known for being associated with certain socio-demographical characteristics (female sex and middle-old age) and with important medical-psychiatric morbidity. Moreover, it has a high impact on workload of GPs. However, we have poor literature about long-term studies on Frequent Attenders (FAs) and persistent FAs.

Objectives

To re-evaluate a group of patients of FAs after nine years since first assessment; to determine the existence of others FAs and possible differences between persistent and occasional FAs.

Methods

Consultation of computerized data on 168 patients between 2001 and 2009; interwiew to the GP and the assistant.

Setting

A primary health care center in Fiorano Modenese (Modena, Northern Italy).

Patients

56 persistent FAs, 56 occasional FAs, 56 non FAs.

Main outcome results: Twenty-eight of 40 patients (70%) evaluated in 2001 were found to be persistent FAs, most frequently older women. Medical morbidity was frequent among persistent FAs, and intermediate among occasional FAs, while psychiatric morbidity does not show important differences between the two groups; however, depression was present in 46% of persistent FAs and in 41% of occasional FAs, while somatization only in occasional FAs (10%), and not among persistent FAs. Persistent FAs received more prescriptions for all types of drugs, while among the occasional FAs the requests for a psychiatric treatment were higher.

Conclusions

The phenomenon of frequent attendance has a large amount and claims for further studies. Psychiatric morbidity between persistent and occasional FAs might have different expressions, requiring different clinical approaches to be specifically tailored.

Type
P03-529
Copyright
Copyright © European Psychiatric Association 2011
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