Family Practice Vol. 20, No. 4, 434-440
© Oxford University Press 2003
International Health Care Research |
Tiredness in Dutch family practice. Data on patients complaining of and/or diagnosed with ‘tiredness’
Family Physician, Haarlem and
a Department of Family Practice, Division of Clinical Methods and Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Correspondence to Dr IM Okkes; E-mail: i.m.okkes{at}amc.uva.nl
Background. Research including patients from the entire tiredness spectrum in family practice is needed.
Objectives. Our aim was to provide routine family practice data on (i) relationships between the RFE (reason for encounter) and the diagnosis ‘tiredness’; (ii) duration, number of encounters and family physician’s (FP’s) interventions in episodes of care of tiredness; and (iii) sex/age and co-morbidity of patients diagnosed with ‘tiredness’.
Methods. Routine episode of care data from the Transition Project, coded comprehensively with the International Classification of Primary Care (ICPC), were used. (i) A 16 year database (1985–2000, 58 FPs, 504 145 episodes of care, 168 550 patient years) for calculating ‘prior probabilities’ with (diagnostic) odds ratios. (ii) A ‘basic population’ extracted from that 16 year database of patients listed for an entire 4 year period (1997–2000; n = 12 292).
Results. The RFE tiredness resulted in a variety of diagnoses, but most frequently (43%) in ‘tiredness’. Most odds ratios were low or negative. Of episodes of care of tiredness, 90% started with the RFE tiredness; 72% required one encounter only, and 90% lasted <6 months. In the 4 year period, 21% of patients first presented with tiredness, and 12% were diagnosed with tiredness; both groups were skewed towards women. Average co-morbidity in tired patients (16.6) was higher than in other visiting patients (10.4), and contained more tiredness-related conditions. FPs’ interventions were mainly blood test, physical exam and advice; few referrals occurred.
Conclusions. For many diagnoses, the RFE tiredness hardly contributes to the Bayesian posterior probability. FPs react differently to the RFE tiredness in cases in which they diagnose the patient with ‘tiredness’ from how they react in other cases. The characteristics of ICPC and the Dutch health care system resulted in a full integration of tiredness as an RFE and as a freestanding episode of care in the context of family practice.
Keywords. Episode of care, family practice, probability, reason for encounter, tiredness.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H Koch, M. van Bokhoven, P. Bindels, T van der Weijden, G. Dinant, and G ter Riet The course of newly presented unexplained complaints in general practice patients: a prospective cohort study Fam. Pract., December 1, 2009; 26(6): 455 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Nijrolder, D. van der Windt, H. de Vries, and H. van der Horst Diagnoses during follow-up of patients presenting with fatigue in primary care Can. Med. Assoc. J., November 10, 2009; 181(10): 683 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. van Bokhoven, H. Koch, T. van der Weijden, R. P. T. M. Grol, A. D. Kester, P. E. L. M. Rinkens, P. J. E. Bindels, and G.-J. Dinant Influence of Watchful Waiting on Satisfaction and Anxiety Among Patients Seeking Care for Unexplained Complaints Ann. Fam. Med, March 1, 2009; 7(2): 112 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Nijrolder, D. A.W.M. van der Windt, and H. E. van der Horst Prognosis of Fatigue and Functioning in Primary Care: A 1-Year Follow-up Study Ann. Fam. Med, November 1, 2008; 6(6): 519 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Eberl, R. L. Phillips Jr, H. Lamberts, I. Okkes, and M. C. Mahoney Characterizing Breast Symptoms in Family Practice Ann. Fam. Med, November 1, 2008; 6(6): 528 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Wearden and C. Chew-Graham Managing chronic fatigue syndrome in UK primary care: challenges and opportunities Chronic Illness, June 1, 2006; 2(2): 143 - 153. [Abstract] [PDF]
|
|
|
|
|
|
W. T Hamilton, A. M Gallagher, J. M Thomas, and P. D White The prognosis of different fatigue diagnostic labels: a longitudinal survey Fam. Pract., August 1, 2005; 22(4): 383 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M Gallagher, J. M Thomas, W. T Hamilton, and P. D White Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001 J R Soc Med, December 1, 2004; 97(12): 571 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Hamilton and D. Sharp Diagnosis of lung cancer in primary care: a structured review Fam. Pract., December 1, 2004; 21(6): 605 - 611. [Abstract] [Full Text] [PDF]
|
|