+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Does fear of serious disease predict consulting behaviour amongst patients with dyspepsia in general practice?



Does fear of serious disease predict consulting behaviour amongst patients with dyspepsia in general practice?



European Journal of Gastroenterology and Hepatology 11(8): 881-886



There have been relatively few studies of health care utilization amongst patients with upper gastrointestinal (GI) complaints. We postulated that health care utilization amongst patients with dyspepsia is primarily driven by fear of serious disease. Consecutive patients presenting to primary care with dyspepsia were questioned about their health care utilization over a 12-month pre-consultation period. The patients completed a questionnaire which included validated measures of GI symptoms (including symptom frequency, duration and severity), and the shortened neuroticism scale of the Eysenck Personality Questionnaire. In total, 614 patients were recruited into the study, and 596 patients provided details of their health care utilization. Previous health care utilization was defined as one or more primary care visits for upper GI symptoms in the 12 months prior to the index visit; frequent health care utilization was defined as six or more visits over the same period. Previous health care utilization was reported by 80% of patients, while frequent health care utilization was reported by 26% of patients. Fear of serious illness and fear of cancer were univariately associated with previous and frequent health care utilization (both P = 0.001). However, the only independent predictors of previous health care utilization were frequent dyspepsia (odds ratio (OR) = 2.17), pain-related anxiety (OR = 2.08-4.66) and higher neuroticism scores (OR = 1.12); independent predictors of frequent health care utilization were frequent dyspepsia (OR = 3.25), pain-related anxiety (OR = 1.74-6.08), female gender (OR = 1.73) and being a non-drinker (OR = 1.72). Health care utilization was not independently associated with symptom severity or duration, or with patients' characteristics, such as age, marital status, ethnicity, smoking status or the use of non-steroidal antiinflammatory drugs. Consulting behaviour amongst patients with dyspepsia is driven in part by psychological factors and, in particular, by symptom-related anxiety as well as by the frequency of dyspepsia, but not primarily by fear of serious disease. Anxiety may help sustain health care utilization once the behaviour has been established.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 045823667

Download citation: RISBibTeXText

PMID: 10514121

DOI: 10.1097/00042737-199908000-00012


Related references

Fluctuation in dyspepsia subgroups over time. A three-year follow-up of patients consulting general practice for dyspepsia. Digestive & Liver Disease 34(5): 332-338, 2002

Patient education about cough: effect on the consulting behaviour of general practice patients. British Journal of General Practice 41(348): 289-292, 1991

Dyspepsia classification pocket chart based on symptoms in 7270 dyspepsia patients from general practice Evidence for two types of esophageal dyspepsia. Gastroenterology 116(4 PART 2): A80, 1999

Evaluation of the diagnostic efficacy of patients with dyspepsia in the consulting between internists and general practitioners. Medicina Clinica 123(10): 374-380, 2004

Association between dyspepsia and weather An analysis of 7266 dyspepsia patients from general practice. Gastroenterology 118(4 Suppl 2 Part 2): AGA A1090, 2000

Prognosis of dyspepsia among patients in general practice Dyspepsia subgroups and patient characteristics. Gastroenterology 110(4 SUPPL ): A29, 1996

Classification of dyspepsia: Identification of independent symptom components in 7270 consecutive, unselected dyspepsia patients from general practice. Scandinavian Journal of Gastroenterology 33(12): 1262-1272, 1998

Effects of systematic patient education about cough on the consulting behaviour of a general practice population. Patient Education and Counseling 22(3): 127-132, 1993

"Patients consulting the physician in private practice--selected results of a survey of general practice". Gesundheitswesen ) 56(11): 641, 1994

The acceptability to patients of video-consulting in general practice: semi-structured interviews in three diverse general practices. Journal of Innovation in Health Informatics 23(2): 141, 2018

Use of email for consulting with patients in general practice. British Journal of General Practice 63(610): 238-238, 2014

Use of email for consulting with patients in general practice. British Journal of General Practice 63(608): 118-119, 2013

Antibiotic treatment failure when consulting patients with respiratory tract infections in general practice. A qualitative study to explore Danish general practitioners' perspectives. European Journal of General Practice 23(1): 120-127, 2018

A German Drug-Monitoring Study in General Practice Patients Receiving Cisapride for Functional Dyspepsia: General Discussion. Scandinavian Journal of Gastroenterology 28(S195): 54-59, 1993

Standardized patients in the assessment of general practice consulting skills. Medical Education 32(1): 8-13, 1998