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Symptoms as the main problem in primary care: A cross-sectional study of frequency and characteristics.

Rosendal M, Carlsen AH, Rask MT, Moth G - Scand J Prim Health Care (2015)

Bottom Line: GPs expected that presented symptoms would not result in a future specific diagnosis for half of these patients.Higher burden was associated with age, comorbidity, and GP expectancy of persistent symptoms when no diagnosis could be made.More attention should be directed to evidence-based management of symptoms as a generic phenomenon to ensure improved outcomes in the future.

View Article: PubMed Central - PubMed

Affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University , Denmark.

ABSTRACT

Objective: The aim was to study symptoms managed as the main problem by the general practitioner (GP) and to describe the frequencies and characteristics of presented symptoms when no specific diagnosis could be made.

Design: Cross- sectional study.

Setting: General practices in the Central Denmark Region.

Subjects: In total, 397 GPs included patients with face-to-face contacts during one randomly assigned day in 2008-2009; 7008 patients were included and 5232 presented with a health problem.

Main outcome measures: GPs answered a questionnaire after each patient contact. Symptoms and specific diagnoses were subsequently classified using the International Classification of Primary Care (ICPC). Symptom frequency, comorbidity, consultation length, and GP-assessed final outcome and burden of consultations were analysed.

Results: The GPs could not establish a specific diagnosis in 36% of patients with health problems. GPs expected that presented symptoms would not result in a future specific diagnosis for half of these patients. Musculoskeletal (lower limb and back) and respiratory (cough) symptoms were most frequent. More GPs had demanding consultations when no specific diagnosis could be made. Higher burden was associated with age, comorbidity, and GP expectancy of persistent symptoms when no diagnosis could be made.

Conclusion: Interpretation and management of symptoms is a key task in primary care. As symptoms are highly frequent in general practice, symptoms without a specific diagnosis constitute a challenge to GPs. Nevertheless, symptoms have been given little priority in research. More attention should be directed to evidence-based management of symptoms as a generic phenomenon to ensure improved outcomes in the future.

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Related in: MedlinePlus

Flow of patient inclusion.
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Related In: Results  -  Collection

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Figure 1: Flow of patient inclusion.

Mentions: For the purpose of the present paper, we included GP face-to-face contacts (consultations and home visits) with patients identified by their civil registration number (ID). Contacts with missing IDs could not be associated with individuals and were excluded. Half of these (n = 388) were caused by 20 GPs who chose not to state the ID of their patients. If the patients appeared more than once, only their first contact was included in the study (Figure 1).


Symptoms as the main problem in primary care: A cross-sectional study of frequency and characteristics.

Rosendal M, Carlsen AH, Rask MT, Moth G - Scand J Prim Health Care (2015)

Flow of patient inclusion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834508&req=5

Figure 1: Flow of patient inclusion.
Mentions: For the purpose of the present paper, we included GP face-to-face contacts (consultations and home visits) with patients identified by their civil registration number (ID). Contacts with missing IDs could not be associated with individuals and were excluded. Half of these (n = 388) were caused by 20 GPs who chose not to state the ID of their patients. If the patients appeared more than once, only their first contact was included in the study (Figure 1).

Bottom Line: GPs expected that presented symptoms would not result in a future specific diagnosis for half of these patients.Higher burden was associated with age, comorbidity, and GP expectancy of persistent symptoms when no diagnosis could be made.More attention should be directed to evidence-based management of symptoms as a generic phenomenon to ensure improved outcomes in the future.

View Article: PubMed Central - PubMed

Affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University , Denmark.

ABSTRACT

Objective: The aim was to study symptoms managed as the main problem by the general practitioner (GP) and to describe the frequencies and characteristics of presented symptoms when no specific diagnosis could be made.

Design: Cross- sectional study.

Setting: General practices in the Central Denmark Region.

Subjects: In total, 397 GPs included patients with face-to-face contacts during one randomly assigned day in 2008-2009; 7008 patients were included and 5232 presented with a health problem.

Main outcome measures: GPs answered a questionnaire after each patient contact. Symptoms and specific diagnoses were subsequently classified using the International Classification of Primary Care (ICPC). Symptom frequency, comorbidity, consultation length, and GP-assessed final outcome and burden of consultations were analysed.

Results: The GPs could not establish a specific diagnosis in 36% of patients with health problems. GPs expected that presented symptoms would not result in a future specific diagnosis for half of these patients. Musculoskeletal (lower limb and back) and respiratory (cough) symptoms were most frequent. More GPs had demanding consultations when no specific diagnosis could be made. Higher burden was associated with age, comorbidity, and GP expectancy of persistent symptoms when no diagnosis could be made.

Conclusion: Interpretation and management of symptoms is a key task in primary care. As symptoms are highly frequent in general practice, symptoms without a specific diagnosis constitute a challenge to GPs. Nevertheless, symptoms have been given little priority in research. More attention should be directed to evidence-based management of symptoms as a generic phenomenon to ensure improved outcomes in the future.

Show MeSH
Related in: MedlinePlus