TY - JOUR T1 - Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study JF - British Journal of General Practice JO - Br J Gen Pract SP - e729 LP - e736 DO - 10.3399/bjgp16X686569 VL - 66 IS - 651 AU - Samuel Malins AU - Joe Kai AU - Christopher Atha AU - Anthony Avery AU - Boliang Guo AU - Marilyn James AU - Shireen Patel AU - Christopher Sampson AU - Michelle Stubley AU - Richard Morriss Y1 - 2016/10/01 UR - http://bjgp.org/content/66/651/e729.abstract N2 - Background Most frequent attendance in primary care is temporary. Long-term frequent attendance may be suitable for psychological intervention to address health management and service use.Aim To explore the feasibility and acceptability of cognitive behaviour therapy (CBT) for long-term frequent attendance in primary care and obtain preliminary evidence regarding clinical and cost effectiveness.Design and setting A CBT case series was carried out in five GP practices in the East Midlands.Method Frequent attenders (FAs) were identified from case notes and invited by their practice for assessment, then offered CBT. Feasibility and acceptability were assessed by CBT session attendance and thematic analysis of semi-structured questionnaires. Clinical and cost effectiveness was assessed by primary care use and clinically important change on a range of health and quality of life instruments.Results Of 462 FAs invited to interview, 87 (19%) consented to assessment. Thirty-two (7%) undertook CBT over a median of 3 months. Twenty-four (75%) attended at least six sessions. Eighteen FAs (86%, n = 21) reported overall satisfaction with treatment. Patients reported valuing listening without judgement alongside support to develop coping strategies. Thirteen (54%, n = 24), achieved clinically important improvement on the SF-36 Mental-Component Scale at 6-month follow-up and improved quality of life, but no improvement on other outcomes. Primary care use reduced from a median of eight contacts in 3 months at baseline (n = 32) to three contacts in 3 months at 1 year (n = 18).Conclusion CBT appears feasible and acceptable to a subset of long-term FAs in primary care who halved their primary care use. With improved recruitment strategies, this approach could contribute to decreasing GP workload and merits larger-scale evaluation. ER -