Patients with psychological ICPC codes in primary care; a case-control study investigating the decade before presenting with problems

Abstract

Background: Recognizing patients with psychological problems can be difficult for general practitioners (GPs). Use of information collected in electronic medical records (EMR) could facilitate recognition. Objectives: To assess relevant EMR parameters in the decade before patients present with psychological problems. Methods: Exploratory case-control study assessing EMR parameters of 58 228 patients recorded between 2013 and 2015 by 54 GPs. We compared EMR parameters recorded before 2014 of patients who presented with psychological problems in 2014 with those who did not. Results: In 2014, 2406 patients presented with psychological problems. Logistic regression analyses indicated that having registrations of the following statistically significant parameters increased the chances of presenting with psychological problems in 2014: prior administration of a depression severity questionnaire (odds ratio (OR): 3.3); fatigue/sleeping (OR: 1.6), neurological (OR: 1.5), rheumatic (OR: 1.5) and substance abuse problems (OR: 1.5); prescriptions of opioids (OR: 1.3), antimigraine preparations (OR: 1.5), antipsychotics (OR: 1.7), anxiolytics (OR: 1.4), hypnotics and sedatives (OR: 1.4), antidepressants (OR: 1.7), and antidementia drugs (OR: 2.1); treatment with minimal interventions (OR: 2.2) and physical exercise (OR: 3.3), referrals to psychology (OR: 1.5), psychiatry (OR: 1.6), and psychosocial care (OR: 2.1); double consultations (OR: 1.2), telephone consultations (OR: 1.1), and home visits (OR: 1.1). Conclusion: This study demonstrates that possible indications of psychological problems can be identified in EMR. Many EMR parameters of patients presenting with psychological problems were different compared with patients who did not.

Keywords

• Psychological problems
• epidemiology
• case-control designs
• anxiety
• depression
• somatization
• surmenage
• sleep