Key result
Borderline depression is linked to ~200% higher frequent attendance alongside polypharmacy, haematological, and genitourinary problems.
Why the study?
Data on factors associated with frequent attendance at family medicine practices by elderly patients were lacking.
Cross-Sectional (n=624)
Yes
Odds Ratio: 3
p-value: p=0.026, 0.005, 0.001
Polypharmacy, haematological and genitourinary problems, and borderline depression are key factors associated with frequent family medicine practice attendance among elderly patients.
May flag high-utilizing elderly patients; hypothesis-generating and should not yet change practice.
INTRODUCTION: 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. AIM: To fill the lack of data on the factors associated with frequent attendance at family medicine practices by the elderly. METHODS: 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. RESULTS: 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. CONCLUSION: Polypharmacy, haematological and genitourinary problems are associated with frequent attendance in elderly patients. Further longitudinal studies are required to validate our findings.
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Rifel et al. (2019) conducted a cross-sectional in Frequent attendance in family medicine practices (n=624). Clinical factors (polypharmacy, haematological/genitourinary problems, depression) vs. Absence of these factors was evaluated on Frequent attendance at family medicine practices (OR ~3, p=0.026, 0.005, 0.001). Polypharmacy (p=0.026), haematological (p=0.005) and genitourinary problems (p=0.001), and borderline depression (OR ~3) were significantly associated with frequent family medicine practice attendance.
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