TY - JOUR
KW - Evidence-Based Medicine
KW - Family Practice/statistics & numerical data
KW - Health Services Misuse/statistics & numerical data
KW - Health Status
KW - Humans
KW - Mental Disorders/diagnosis/psychology/therapy
KW - Office Visits/statistics & numerical data/utilization
KW - Outcome Assessment (Health Care)
KW - Primary Health Care/statistics & numerical data/utilization
KW - Quality of Life
KW - Somatoform Disorders/diagnosis/psychology/therapy
AU - F. T. Smits
AU - K. A. Wittkampf
AU - A. H. Schene
AU - P. J. Bindels
AU - H. C. Van Weert
A1 - 
AB - OBJECTIVE: To analyse which interventions are effective in influencing morbidity, quality of life, and healthcare utilization of frequently attending patients (FAs) in primary care. METHODS: A systematic literature search was performed for articles describing interventions on FAs in primary care (Medline, Embase, and PsycINFO). Outcomes were morbidity, quality of life (QoL), and use of healthcare. Two independent assessors selected all randomized clinical trials (RCT) and assessed the quality of the selected RCTs. Results. Five primary care based RCTs were identified. Three RCTs used frequent attendance to select patients at risk of distress, major depression, and anxiety disorders. These RCTs applied psychological and psychiatric interventions and focused on undiagnosed psychiatric morbidity of FAs. Two of them found more depression-free days and a better QoL after treating major depressive disorder in FAs. No other RCT found any positive effect on morbidity or QoL. Two RCTs studied an intervention which focused on reducing frequent attendance. No intervention significantly lowered attendance. Due to the difference in study settings and the variation in methods of selecting patients, meta-analysis of the results was not possible. CONCLUSION: No study showed convincing evidence that an intervention improves QoL or morbidity of frequent attending primary care patients, although a small effect might be possible in a subgroup of depressed frequent attenders. No evidence was found that it is possible to influence healthcare utilization of FAs.
BT - Scandinavian journal of primary health care
C5 - Medically Unexplained Symptoms
CP - 2
CY - Norway
DO - 10.1080/02813430802112997
IS - 2
JF - Scandinavian journal of primary health care
N2 - OBJECTIVE: To analyse which interventions are effective in influencing morbidity, quality of life, and healthcare utilization of frequently attending patients (FAs) in primary care. METHODS: A systematic literature search was performed for articles describing interventions on FAs in primary care (Medline, Embase, and PsycINFO). Outcomes were morbidity, quality of life (QoL), and use of healthcare. Two independent assessors selected all randomized clinical trials (RCT) and assessed the quality of the selected RCTs. Results. Five primary care based RCTs were identified. Three RCTs used frequent attendance to select patients at risk of distress, major depression, and anxiety disorders. These RCTs applied psychological and psychiatric interventions and focused on undiagnosed psychiatric morbidity of FAs. Two of them found more depression-free days and a better QoL after treating major depressive disorder in FAs. No other RCT found any positive effect on morbidity or QoL. Two RCTs studied an intervention which focused on reducing frequent attendance. No intervention significantly lowered attendance. Due to the difference in study settings and the variation in methods of selecting patients, meta-analysis of the results was not possible. CONCLUSION: No study showed convincing evidence that an intervention improves QoL or morbidity of frequent attending primary care patients, although a small effect might be possible in a subgroup of depressed frequent attenders. No evidence was found that it is possible to influence healthcare utilization of FAs.
PP - Norway
PY - 2008
SN - 1502-7724; 0281-3432
SP - 111
EP - 116
EP - 
T1 - Interventions on frequent attenders in primary care. A systematic literature review
T2 - Scandinavian journal of primary health care
TI - Interventions on frequent attenders in primary care. A systematic literature review
U1 - Medically Unexplained Symptoms
U2 - 18570010
U3 - 10.1080/02813430802112997
VL - 26
VO - 1502-7724; 0281-3432
Y1 - 2008
ER -