Drug prescription for adult frequent attenders in Danish general practice: a population-based study.

Abstract

To analyse the association between daytime frequent attendance in general practice and drug use, i.e. type of drug used and prevalence of polypharmacy. A population-based cross-sectional study of individual face-to-face contacts with 179 Danish general practices (320 general practitioners, GPs) in the county of Northern Jutland, Denmark and the drug use of the 371 897 inhabitants aged 20 and over. Data on contacts and reimbursed drugs were obtained during the year of 1997 from the Health Insurance Registry. Frequent attenders (FAs) were defined as the 10% most FAs in 12 months. We measured the prevalence difference (PD) and the prevalence ratio (PR) of drug use and polypharmacy (drugs from five or more ATC groups) among FAs. FAs received prescriptions in 95% of the cases and utilised 27% of all prescribed drugs. Compared with the 50% least attending patients, the highest absolute prevalence of drug use among FAs was found for antibiotics (PD: 22.6-34.5), strong analgesics and psychotropics (PD: 16.0-38.5) and cardiovascular (PD: 4.2-46.2), musculoskeletal (PD: 16.3-29) and gastrointestinal drugs (PD: 10.8-39.9). The FAs had an increased PR for receiving a drug (1.1-1.6) and their polypharmacy PD was high (4.0-46.3). The association between frequent attendance and the prevalence of polypharmacy was strong (PR = 6.7-36.7). Frequent attendance in general practice is strongly associated with drug use and polypharmacy. FAs account for a high proportion of the prescription workload, and some disease groups are very common among FAs.