High service users: does the clinical psychologist have a role?

Area of Science:

• Primary Care
• Psychology
• Health Services Research

Background:

• High utilization of general practitioner (GP) services by certain patient groups presents a challenge in primary care.
• Understanding the impact of psychological interventions on frequent GP attenders is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

• To evaluate the effectiveness of psychological intervention in modifying the attendance patterns of high-users of GP services.
• To assess patient and GP satisfaction with the psychological intervention provided.

Main Methods:

• A prospective study involving adult patients with over 12 GP consultations in the preceding year.
• Participants were offered a psychological interview with a clinical psychologist.
• Patient records were analyzed for attendance rates one year prior and two years post-intervention; satisfaction questionnaires were administered.

Main Results:

• Psychological intervention led to a significant short-term decrease in GP attendance rates at three months post-intervention compared to non-participants.
• This reduction in attendance was not sustained at 12 and 24 months, with both groups showing similar attendance rates.
• Both GPs and patients reported positive ratings for the psychologist's input and found the psychologist's reports useful.

Conclusions:

• Psychological intervention offers a short-term benefit in reducing GP service utilization among high-attenders.
• The long-term impact on attendance rates was not significant, suggesting a need for further research into sustained interventions.
• The collaborative report from the psychologist was a valued component by both patients and GPs.