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Health-related quality of life among frequent attenders in Swedish primary care: a cross-sectional observational study
Centre for Research and Development, Region Gävleborg, Gävle, Sweden; Department of Psychology, Uppsala Universitet, Uppsala, Sweden.
Centre for Research and Development, Region Gävleborg, Gävle, Sweden; Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
Department of Psychology, Uppsala Universitet, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 7, article id e026855Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to examine health-related quality of life (HRQoL), patient characteristics and reasons for visits to general practitioners (GPs) by frequent attenders (FAs) and a comparison group (CG) in primary care.

METHODS: Patients aged 18-64 years were eligible for the study. Medical records were scrutinised concerning reasons for visits. Questionnaires including short-form health survey (SF-36) were mailed to 331 FAs (≥5 visits at GPs during 2000) and 371 patients in a CG randomly selected from two healthcare centres and returned by 49% and 57%, respectively. FAs' SF-36 health profiles were compared both to CG and general Swedish population norms.

RESULTS: FAs report lower HRQoL than CG and below the general Swedish population norms in all eight SF-36 domains including both mental and physical component summary scores (MCS and PCS). Effect sizes (ESs) for differences between FAs and norms ranged from 0.79 to 1.08 for specific domains and was 0.94 for PCS and 0.71 for MCS. ESs of FAs versus CG ranged between 0.60 and 0.95 for the domains and was 0.76 for PCS and 0.49 for MCS. There were no significant differences between the FAs and CG with regard to sex, being married or cohabiting, number of children in household or educational level. FAs were more often unemployed, obese, slightly older and used complementary medicine more frequently. Except for injuries, all health complaints as classified in 10 categories were more common among FAs than CG, particularly musculoskeletal pain and psychosocial distress related to compromised HRQoL.

CONCLUSION: The HRQoL is compromised in FAs, both when compared with patients who do not often seek care and to general Swedish population norms. Commonly reported reasons for visiting GPs among FAs were musculoskeletal pain and psychosocial distress. Thus, perceived ill health, particularly pain and distress, seems important for high utilisation of healthcare resources.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019. Vol. 9, no 7, article id e026855
Keywords [en]
General medicine (see internal medicine), primary care, public health
National Category
General Practice
Identifiers
URN: urn:nbn:se:oru:diva-75564DOI: 10.1136/bmjopen-2018-026855PubMedID: 31366640OAI: oai:DiVA.org:oru-75564DiVA, id: diva2:1341621
Available from: 2019-08-09 Created: 2019-08-09 Last updated: 2019-08-09Bibliographically approved

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