Adults with a history of abuse more likely to seek care from general practitioner

Adults with a history of abuse contacted their general practitioner 1.5 times more often than those without a history of abuse, according to a small Dutch study published in the European Journal of General Practice.

“Men with a history of abuse, just like women with a history of abuse, contact the general practitioner (GP) more often and suffer from more psychological and social problems,” Anieck M. Lomans, of the department of primary and community care, gender and women’s health at the Radboud University Medical Center in the Netherlands, and colleagues wrote. “The increase in contacts, especially for psychological and social problems, should alert GPs to inquire about a history of abuse.”

Lomans and colleagues evaluated data from adult patients enrolled in a Dutch primary care registration network who indicated that they did or did not have a history of abuse on a questionnaire completed sometime from 2016 to 2019. The voluntary questionnaire was sent to patients electronically to gather contextual information.

Overall, 11,140 patients responded to the questionnaire, among whom 1,271 indicated a history of abuse. Of these adults with a history of abuse, 72.2% were women and a majority (43.4%) were aged 36 to 54 years.

Lomans and colleagues reported that men with a history of abuse contacted their GP about nine times a year and women with a history of abuse about 14 times a year. These adults with a history of abuse sought care almost twice as often as those without a history of abuse for psychological problems (rate ratio = 1.97; P .001) and social problems (rate ratio = 1.93; P .001). In addition, digestive, endocrine and neurological symptoms were 1.5 times more frequent in adults with a history of abuse, according to the researchers.

The study further showed that men with a history of abuse contacted their GP 3.38 times more often per year for a psychological episode of care compared with men without a history of abuse. Moreover, Lomans and colleagues reported that women with a history of abuse contacted the GP 2.83 times more often for psychological care compared with women without a history of abuse. For social episodes of care, adults with a history of abuse contacted their GP 2.14 times more frequently.

“Clinical enquiry alone does not necessarily improve the outcome of patients experiencing past or current abuse,” Lomans and colleagues wrote. “The management of affected patients requires a close relationship between GPs and practice teams on the one hand, and specialist agencies on the other, linking primary care into an intersectional response to violence and abuse.”