Identifying frequent attenders with anxiety complaints, a pilot study in general practice

Anxiety is a very common problem in the general population. Early treatment of anxiety complaints can be beneficial in the prevention of the development of anxiety disorders. Given the burden for both the individual and society in general early intervention when anxiety complaints arise is welcome.
Particularly in general practice there is a group of patients who frequently visit their GP but do so with a variety of (somatic) complaints which can not be traced back to a specific cause. Research shows that these so called frequent attenders might actually have either anxiety complaints or a anxiety disorder. However, since they do not present themselves with these complaints it is very difficult for the GP to identify them and to offer them the necessary care. More active screening of frequent attenders for anxiety might therefore prove beneficial in the identification of frequent attenders with anxiety complaints.
In the current study we examine various different methods for identifying frequent attenders with anxiety complaints, taking into account that patients with chronic diseases, such as cardio-vascular disease and diabetes, might visit their GP more frequently for a valid reason. Earlier studies have not corrected for this fact.

1. It is common to stratify a dataset on gender and age when identifying frequent attenders within general practice. However, this could lead to an oversampling of patients with chronic diseases, e.g., cardio-vascular disease or diabetes. We therefore propose that datasets should also be stratified on presence of chronic disease before frequent attendance is determined.



2. Stratification based on age, gender and chronic disease will result in

a) better responserates from patients themselves

b) better identification of patients with anxiety complaints

one time screening

none, in this pilot study we only screen for the presence of problems. In a follow-up study we will offer those screening positive for anxiety complaints a light form of cognitive behavioral therapy, to be specific, problem solving treatment.