. 2018 Nov;64(11):832-840.

What are the most common conditions in primary care? Systematic review

Affiliations

¹ Medical student, at the University of Alberta in Edmonton. cfinley@ualberta.ca.
² Family medicine resident, at the University of Alberta in Edmonton.
³ Associate Professor in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁴ Associate Professor of Evidence-Based Medicine in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁵ Public Services Librarian at the Health Sciences Library, at the University of Alberta in Edmonton.
⁶ Professor in the School of Public Health, at the University of Alberta in Edmonton.
⁷ Knowledge Translation and Evidence Coordinator for the Alberta College of Family Physicians and Associate Clinical Professor in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁸ Research Associate at the Alberta Research Centre for Health Evidence, at the University of Alberta in Edmonton.
⁹ Professor of Evidence-Based Medicine in the Department of Family Medicine, at the University of Alberta in Edmonton.

PMID: 30429181
PMCID: PMC6234945

What are the most common conditions in primary care? Systematic review

Caitlin R Finley et al. Can Fam Physician. 2018 Nov.

. 2018 Nov;64(11):832-840.

Authors

Affiliations

¹ Medical student, at the University of Alberta in Edmonton. cfinley@ualberta.ca.
² Family medicine resident, at the University of Alberta in Edmonton.
³ Associate Professor in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁴ Associate Professor of Evidence-Based Medicine in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁵ Public Services Librarian at the Health Sciences Library, at the University of Alberta in Edmonton.
⁶ Professor in the School of Public Health, at the University of Alberta in Edmonton.
⁷ Knowledge Translation and Evidence Coordinator for the Alberta College of Family Physicians and Associate Clinical Professor in the Department of Family Medicine, at the University of Alberta in Edmonton.
⁸ Research Associate at the Alberta Research Centre for Health Evidence, at the University of Alberta in Edmonton.
⁹ Professor of Evidence-Based Medicine in the Department of Family Medicine, at the University of Alberta in Edmonton.

PMID: 30429181
PMCID: PMC6234945

Abstract
in English, French

Objective: To identify the most commonly presenting conditions in primary care globally, and to compare common reasons for visits (RFVs) as reported by clinicians and patients, as well as among countries of different economic classifications.

Data sources: Twelve scientific databases were searched up to January 2016, and a dual independent review was performed to select primary care studies.

Study selection: Studies were included if they contained 20 000 visits or more (or equivalent volume by patient-clinician interactions) and listed 10 or more RFVs. Dual independent data extraction of study characteristics and RFV rankings was performed. Data analysis was descriptive, with pooled rankings of RFVs across studies.

Synthesis: Eighteen studies met inclusion criteria (median 250 000 patients or 83 161 visits). Data were from 12 countries across 5 continents. The 10 most common clinician-reported RFVs were upper respiratory tract infection, hypertension, routine health maintenance, arthritis, diabetes, depression or anxiety, pneumonia, acute otitis media, back pain, and dermatitis. The 10 most common patient-reported RFVs were symptomatic conditions including cough, back pain, abdominal symptoms, pharyngitis, dermatitis, fever, headache, leg symptoms, unspecified respiratory concerns, and fatigue. Globally, upper respiratory tract infection and hypertension were the most common clinician-reported RFVs. In developed countries the next most common RFVs were depression or anxiety and back pain, and in developing countries they were pneumonia and tuberculosis. There was a paucity of available data, particularly from developing countries.

Conclusion: There are differences between clinician-reported and patient-reported RFVs to primary care, as well as between developed and developing countries. The results of our review are useful for the development of primary care guidelines, the allocation of resources, and the design of training programs and curricula.

Objectif: Déterminer l’ensemble des raisons de consulter (RDC) les plus fréquentes dans les cliniques de soins primaires et comparer celles que mentionnent les médecins et les patients ainsi que celles qu’on rencontre dans des pays de différentes classifications économiques.

Source des données: On a consulté 12 bases de données scientifiques jusqu’en janvier 2016, pour ensuite effectuer une revue indépendante double afin de retenir les études qui portaient sur les soins primaires.

Choix des études: Pour être retenues, les études devaient contenir au moins 20 000 visites (ou un nombre équivalent d’interactions patient-médecin) et mentionner au moins les 10 RDC les plus fréquentes. On a effectué une extraction indépendante double des données sur les caractéristiques des études et sur le classement des RDC les plus fréquentes. L’analyse des données était descriptive avec une mise en commun des classements des RDC les plus fréquentes dans les diverses études.

Synthèse: Dix-huit études (avec une médiane de 250 000 patients ou de 83 161 visites) respectaient les critères d’inclusion. Les données provenaient de 12 pays répartis sur 5 continents. Les RDC les plus fréquentes rapportées par les médecins étaient les infections des voies respiratoires supérieures, l’hypertension, les examens de santé périodiques, l’arthrite, le diabète, la dépression ou l’anxiété, la pneumonie, l’otite moyenne aigue, le mal de dos et les dermatites. Les RDC les plus fréquemment rapportées par les patients étaient des entités symptomatiques comme la toux, le mal de dos, des symptômes abdominaux, les pharyngites, les dermatites, la fièvre, les céphalées, les symptômes des membres inférieurs, des inconforts respiratoires mal définis et de la fatigue. Dans l’ensemble, les infections des voies respiratoires supérieures et l’hypertension étaient les RDC les plus fréquentes selon les médecins. Dans les pays développés, les RDC qui occupaient les prochains rangs étaient la dépression ou l’anxiété et le mal de dos, tandis que dans les pays en développement, c’était la pneumonie et la tuberculose. Il y avait très peu de données disponibles, en particulier dans les pays en voie de développement.

Conclusion: Il y a des différences entre ce que rapportent les médecins et les patients sur les raisons de consulter un service de soins primaires, mais aussi entre ce qu’on observe dans les pays développés et dans les pays en voie de développement. Les résultats de la présente revue devraient permettre l’élaboration de directives pour les soins primaires, l’allocation de ressources appropriées, et l’instauration de programmes de formation et de curricula spécifiques.

PubMed Disclaimer

Figures

See this image and copyright information in PMC

References

1. Green LA, Fryer GE, Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001;344(26):2021–5. - PubMed
1. Stewart M, Ryan B. Ecology of health care in Canada. Can Fam Physician. 2015;61:449–53. - PMC - PubMed
1. Roland M, Guthrie B, Thomé DC. Primary medical care in the United Kingdom. J Am Board Fam Med. 2012;25(Suppl 1):S6–11. - PubMed
1. Starfield B, Lemke KW, Bernhardt T, Foldes SS, Forrest CB, Weiner JP. Comorbidity: implications for the importance of primary care in ‘case’ management. Ann Fam Med. 2003;1(1):8–14. - PMC - PubMed
1. Chang CH, Stukel TA, Flood AB, Goodman DC. Primary care physician workforce and Medicare beneficiaries’ health outcomes. JAMA. 2011;305(20):2096–104. Erratum in: JAMA 2011;306(2):162. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

What are the most common conditions in primary care? Systematic review

Affiliations

What are the most common conditions in primary care? Systematic review

Authors

Affiliations

Abstract
in English, French

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Miscellaneous

Abstract in English, French

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Miscellaneous

Abstract
in English, French