Rifel Janez, Selic Polona
Department of Family Medicine, Faculty of Medicine, University in Ljubljana, Ljubljana, Slovenia.
Mater Sociomed. 2019 Jun;31(2):93-98. doi: 10.5455/msm.2019.31.93-98.
Frequent attendance in family medicine practices is associated with elderly patients and those with chronic diseases. Longstanding frequent attendees have more social and psychiatric problems, medically unexplained conditions, and chronic diseases, and are prescribed more psychotropic drugs and analgesics.
To fill the lack of data on the factors associated with frequent attendance at family medicine practices by the elderly.
Forty family physicians (FPs) participated in this cross-sectional study in 2017 and randomly recruited up to 20 of their patients; 624 patients were recruited. From the patients' health records, the FPs collected demographic data, lifestyle factors, all the patients' diagnoses, all the drugs prescribed in the previous 12 months, multi-morbidity (CIRS-G index), the quality of life index (EQ-5D) and the number of visits to the family medicine practice in the previous 12 months. The Self-Rating Depression Scale was administered to the patients. Statistical analysis was carried out using the IBM SPSS 20.0 package, with appropriate non-parametric tests (Mann-Whitney U test, chi-square test) to check significant differences between groups of patients. Multivariate modelling was carried out to evaluate the associations between the number of visits to the FP and independent variables.
The number of prescribed drugs (p=0.026), haematological problems (p=0.005) and genitourinary problems (p=0.001) were associated with frequent attendance. Patients with borderline depression were approximately three times more likely to be frequent attendees than non-depressed patients.
Polypharmacy, haematological and genitourinary problems are associated with frequent attendance in elderly patients. Further longitudinal studies are required to validate our findings.
在家庭医疗诊所频繁就诊与老年患者以及患有慢性病的患者相关。长期频繁就诊者存在更多社会和精神问题、医学上无法解释的病症以及慢性病,并且被开具更多的精神药物和镇痛药。
填补关于老年患者在家庭医疗诊所频繁就诊相关因素数据的空白。
40名家庭医生于2017年参与了这项横断面研究,他们各自随机招募了至多20名患者;共招募了624名患者。家庭医生从患者的健康记录中收集了人口统计学数据、生活方式因素、所有患者的诊断结果、过去12个月内开具的所有药物、多重疾病(CIRS - G指数)、生活质量指数(EQ - 5D)以及过去12个月内在家庭医疗诊所的就诊次数。对患者进行了自评抑郁量表测试。使用IBM SPSS 20.0软件包进行统计分析,采用适当的非参数检验(曼 - 惠特尼U检验、卡方检验)来检查患者组之间的显著差异。进行多变量建模以评估家庭医生就诊次数与自变量之间的关联。
开具药物的数量(p = 0.026)、血液学问题(p = 0.005)和泌尿生殖系统问题(p = 0.001)与频繁就诊相关。处于边缘抑郁状态的患者成为频繁就诊者的可能性是非抑郁患者的约三倍。
多种药物治疗、血液学和泌尿生殖系统问题与老年患者频繁就诊相关。需要进一步的纵向研究来验证我们的发现。