PT  - JOURNAL ARTICLE
AU  - Juan Ángel Bellón
AU  - Antonina Rodríguez-Bayón
AU  - Juan de Dios Luna
AU  - Francisco Torres-González
TI  - Successful GP intervention with frequent attenders in primary care: randomised controlled trial
AID  - 10.3399/bjgp08X280182
DP  - 2008 May 01
TA  - British Journal of General Practice
PG  - 324--330
VI  - 58
IP  - 550
4099  - http://bjgp.org/content/58/550/324.short
4100  - http://bjgp.org/content/58/550/324.full
SO  - Br J Gen Pract2008 May 01; 58
AB  - Background Frequent attenders to GP clinics can place an unnecessary burden on primary care. Interventions to reduce frequent attendance have had mixed results.Aim To assess the effectiveness of a GP intervention to reduce frequent-attender consultations.Design of study Randomised controlled trial with frequent attenders divided into an intervention group and two control groups (one control group was seen by GPs also providing care to patients undergoing the intervention).Setting A health centre in southern Spain.Method Six GPs and 209 randomly-selected frequent attenders participated. Three GPs were randomly allocated to perform the new intervention: of the 137 frequent attenders registered with these three GPs, 66 were randomly allocated to receive the intervention (IG) and 71 to a usual care control group (CG2). The other three GPs offered usual care to the other 72 frequent attenders (CG1). The main outcome measure was the total number of consultations 1 year post-intervention. Baseline measurements were recorded of sociodemographic characteristics, provider–user interface, chronic illnesses, and psychosocial variables. GPs allocated to the new intervention received 15 hours' training which incorporated biopsychosocial, organisational, and relational approaches. After 1 year of follow-up frequent attenders were contacted. An intention-to-treat analysis was used.Results A multilevel model was built with three factors: time, patient, and doctor. After adjusting for covariates, the mean number of visits at 1 year in IG was 13.10 (95% confidence interval [CI] = 11.39 to 14.94); in the CG1 group was 19.37 (95% CI = 17.31 to 21.55); and in the CG2 group this was 16.72 (95% CI =14.84 to 18.72).Conclusion The new intervention with GPs resulted in a significant and relevant reduction in frequent-attender consultations. Although further trials are needed, this intervention is recommended to GPs interested in reducing consultations by their frequent attenders.