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Unexplained Complaints in General Practice: Prevalence, Patients' Expectations, and Professionals' Test-Ordering Behavior

Unexplained Complaints in General Practice: Prevalence, Patients' Expectations, and... Objective. To gain insight into general practitioners' (GPs) test-ordering behavior for patients presenting with unexplained complaints. An unexplained complaint's symptoms are not alarming, and there is no plausible medical or psychosocial explanation for it. The Dutch College of General Practitioners (DCGP) recommends a watchful, waiting attitude for test ordering for unexplained complaints. Methods. Observational, cross-sectional study of 567 doctor-patient consultations performed by 21 GPs. Results. On average, 13% of consultations involved complaints considered unexplained by GPs. Unexplained complaints were positively related to test ordering (adjusted odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.1-5.3), despite the DCGP's recommendation. Patients' expectations about testing influenced test ordering even more (adjusted OR = 4.1, 95% CI 2.2-7.6). Discussion. Unexplained complaints happen daily in general practice. Besides the DCGP's recommendation, factors such as GPs' desire to understand complaints and patients' expectations seem to have impacts. Guideline development and quality improvement projects should respect, next to Bayesian rules, GP- and patient-related determinants of test ordering. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medical Decision Making SAGE

Unexplained Complaints in General Practice: Prevalence, Patients' Expectations, and Professionals' Test-Ordering Behavior

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References (21)

Publisher
SAGE
Copyright
Copyright © by SAGE Publications
ISSN
0272-989X
eISSN
1552-681X
DOI
10.1177/0272989X03023003004
pmid
12809320
Publisher site
See Article on Publisher Site

Abstract

Objective. To gain insight into general practitioners' (GPs) test-ordering behavior for patients presenting with unexplained complaints. An unexplained complaint's symptoms are not alarming, and there is no plausible medical or psychosocial explanation for it. The Dutch College of General Practitioners (DCGP) recommends a watchful, waiting attitude for test ordering for unexplained complaints. Methods. Observational, cross-sectional study of 567 doctor-patient consultations performed by 21 GPs. Results. On average, 13% of consultations involved complaints considered unexplained by GPs. Unexplained complaints were positively related to test ordering (adjusted odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.1-5.3), despite the DCGP's recommendation. Patients' expectations about testing influenced test ordering even more (adjusted OR = 4.1, 95% CI 2.2-7.6). Discussion. Unexplained complaints happen daily in general practice. Besides the DCGP's recommendation, factors such as GPs' desire to understand complaints and patients' expectations seem to have impacts. Guideline development and quality improvement projects should respect, next to Bayesian rules, GP- and patient-related determinants of test ordering.

Journal

Medical Decision Making – SAGE

Published: May 1, 2003

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