WHAT ARE THE MOST COMMON CONDITIONS IN PRIMARY CARE?
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1 WHAT ARE THE MOST COMMON CONDITIONS IN PRIMARY CARE? Finley C, Chan DS, Garrison S, Korownyk C, Kolber MR, Campbell S, Eurich D, Lindblad A, Vandermeer B, Allan GM.
2 DISCLOSURE/COI Caitlin Finley, University of Alberta Relationships with commercial interests: Grants/Research Support None Speakers Honoraria None Consulting Fees None Other - None
3
4 BACKGROUND What do you think are the most common conditions in primary care? No systematic review looking at the most common conditions in primary care Identify priorities for researchers, administrators, and policy makers Planning and allocation of resources, guide training of primary care professionals
5 OBJECTIVES To systematically identify the reasons patients visit primary care globally; To compare presentations to primary care between developed & developing countries.
6 METHODS Inclusion: 1) Study setting was general practice and/or primary care; 2) Minimum of 10 reasons for visits; 3) Minimum visits (or equivalent) Exclusion: 1) Focused on a specific type of condition or presentation (e.g. periodic health exam visits); 2) Focused on specific conditions or problems (e.g. acute conditions, opioid use); 3) Selected specific populations (e.g. adolescents); 4) Indicated that study population was referred to primary care (e.g. to pediatrics or internal medicine); 5) Were published before 1996 (i.e and earlier publication date)
7 STUDY FLOW 18 studies included in final assessment 10 reported specific reasons for visits (14 analyses) Remaining studies included for subgroup analysis
8 STUDY CHARACTERISTICS # of studies Range Number of visits 16 4, ,800,000 Number of clinicians ,400 Population served 7 9,896 2,780,270 Sampling duration 15 1 day 11 years Years of data collection
9 STUDY CHARACTERISTICS
10 QUALITY ASSESSMENT Criteria Low quality High quality Representative sample of clinicians 7 11 Representative sample of patients 1 17 Used a defined coding system 3 15 Prolonged data collection (³1 year) 4 14 Data collected prospectively (vs. retrospectively) 3 15
11 RESULTS I Clinician-reported and patientreported results
12 Clinician Reported Patient Reported Rank Condition Rank Condition 1 Upper Respiratory Tract Infection, Unspecified 1 Cough 2 Hypertension 2 Back Pain/ Spinal Pain 3 Routine Health Maintenance 3 Abdominal unspecified 4 Arthritis (not back) 4 Pharyngitis 5 Diabetes 5 Dermatitis 6 Depression or Anxiety 6 Fever 7 Pneumonia 7 Headache 8 Acute Otitis Media 8 Leg Symptoms 9 Back Pain/ Spinal Pain 9 Respiratory unspecified 10 Dermatitis 10 Fatigue 11 Cough 11 Depression or Anxiety 12 Urinary Tract Infection 12 Arthritis (not back)
13 Clinician Reported Patient Reported Rank Condition Rank Condition 1 Upper Respiratory Tract Infection, Unspecified 1 Cough 2 Hypertension 2 Back Pain/ Spinal Pain 3 Routine Health Maintenance 3 Abdominal unspecified 4 Arthritis (not back) 4 Pharyngitis 5 Diabetes 5 Dermatitis 6 Depression or Anxiety 6 Fever 7 Pneumonia 7 Headache 8 Acute Otitis Media 8 Leg Symptoms 9 Back Pain/ Spinal Pain 9 Respiratory unspecified 10 Dermatitis 10 Fatigue 11 Cough 11 Depression or Anxiety 12 Urinary Tract Infection 12 Arthritis (not back)
14 RESULTS II Developed and developing countries results
15 Developed Countries Developing Countries Rank Condition Rank Condition 1 Hypertension 1 2 Upper Respiratory Tract Infection, Unspecified Upper Respiratory Tract Infection, Unspecified 2 Hypertension
16 Developed Countries Developing Countries Rank Condition Rank Condition 1 Hypertension 1 2 Upper Respiratory Tract Infection, Unspecified Upper Respiratory Tract Infection, Unspecified 2 Hypertension 3 Depression or Anxiety 3 Pneumonia 4 Back Pain 4 Tuberculosis 5 Routine Health Maintenance 5 Parasites 6 Arthritis (not back) 6 Anemia 7 Dermatitis 7 Diabetes 8 Acute Otitis Media 8 Arthritis (not back) 9 Diabetes 9 Bronchitis/ bronchiolitis 10 Cough 10 Epilepsy 11 Medication 11 Urinary Tract Infection 12 Urinary Tract Infection 12 Tonsillitis
17 CONCLUSIONS Primary care physicians see a wide variety of conditions, involving many body systems and specialties Differences exist between: Clinician-reported and patient-reported reasons for visits, and Developed and developing countries regarding common conditions
18 QUESTIONS?
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