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dc.contributor.authorMalins, Samuel
dc.date.accessioned2017-08-24T14:57:00Z
dc.date.available2017-08-24T14:57:00Z
dc.date.issued2012
dc.identifier.citationMorriss, R., Kai, J., Atha, C., Avery, A., Bayes, S., Franklin, M., George, T., James, M., Malins, S., McDonald, R., et al. (2012). Persistent frequent attenders in primary care: Costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention. BMC Family Practice, 13 (39), pp.1-14.
dc.identifier.other10.1186/1471-2296-13-39
dc.identifier.urihttp://hdl.handle.net/20.500.12904/2277
dc.description© Morriss et al.; licensee BioMed Central Ltd. 2012 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.description.abstractBackground: The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance). However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT) for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design: A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (>= 30 appointments with general practitioner [ GP] over 2 years) with 100 normal attenders (6-22 appointments with GP over 2 years), from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion: The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will be piloted with a view to developing this approach as part of a multifaceted intervention.
dc.description.urihttps://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-13-39
dc.formatFull text uploaded
dc.subjectCognitive behavioural therapy
dc.subjectAttitude to health
dc.subjectCosts and cost analysis
dc.subjectMental disorders
dc.subjectPrimary health care
dc.titlePersistent frequent attenders in primary care: Costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention
dc.typeArticle
refterms.dateFOA2021-06-07T12:54:54Z
html.description.abstractBackground: The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance). However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT) for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design: A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (>= 30 appointments with general practitioner [ GP] over 2 years) with 100 normal attenders (6-22 appointments with GP over 2 years), from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion: The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will be piloted with a view to developing this approach as part of a multifaceted intervention.


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