Search tips
Search criteria 


Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 1994 June; 44(383): 259–262.
PMCID: PMC1238897

Consultation rates and incidence of intercurrent morbidity among patients with chronic disease in general practice.


BACKGROUND. Information on frequency of consultation and presented morbidity among patients with chronic disease is relevant to the management of these patients in view of the increasing prevalence of chronic diseases. AIM. This study set out to examine consultation rates and incidence of intercurrent morbidity in general practice in cohorts of patients with five common chronic diseases: hypertension, chronic ischaemic heart disease, diabetes mellitus, chronic respiratory disease and osteoarthritis. METHOD. In seven practices with 15 general practitioners the records of all patients were screened for inclusion in the study. The data used for analysis were from 962 patients, whose diagnoses were made in agreement with diagnostic criteria, who were not under specialist care, and who were followed up for 21 months. A distinction was made between patients with one, or two or more of the five chronic diseases studied. For the single disease subgroups of patients with hypertension or diabetes two reference groups of people without a chronic disease, standardized for age and sex, were identified from the population in the same practices. RESULTS. Consultation rates were higher for patients with comorbidity than for patients with a single disease. Intercurrent diseases were presented more frequently to the general practitioner by patients with comorbidity than by patients with a single disease. Most intercurrent morbidity consisted of acute common diseases such as myalgia, upper respiratory tract infection and urinary tract infection. Patients with only hypertension or only diabetes had higher consultation rates than the corresponding reference group but did not have higher total incidence rates of intercurrent morbidity. CONCLUSION. Patients with chronic disease consult their general practitioner frequently, and patients with more than one chronic disease consult even more frequently. The general practitioner has to deal with chronic disease and intercurrent acute disease in a single patient.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (903K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Olshansky SJ, Ault AB. The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q. 1986;64(3):355–391. [PubMed]
  • Schellevis FG, van der Velden J, van de Lisdonk E, van Eijk JT, van Weel C. Comorbidity of chronic diseases in general practice. J Clin Epidemiol. 1993 May;46(5):469–473. [PubMed]
  • Schellevis FG, van de Lisdonk E, van der Velden J, van Eijk JT, van Weel C. Validity of diagnoses of chronic diseases in general practice. The application of diagnostic criteria. J Clin Epidemiol. 1993 May;46(5):461–468. [PubMed]
  • van Weel C. Does labelling and treatment for hypertension increase illness behaviour? Fam Pract. 1985 Sep;2(3):147–150. [PubMed]
  • Beale N, Searle M, Woodman J. Use made by patients of chronic disease surveillance consultations in general practice. Br J Gen Pract. 1992 Feb;42(355):51–53. [PMC free article] [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners