Profile of European frequent attenders in primary health care: a systematic review and meta-analysis.

Abstract

Introduction: Frequent attendance is a phenomenon that increases health expenses and affects the environment and development of health-related activities, reducing the quality of the assistance provided and increasing care pressure. This problem is intensified in primary health care (PHC) due to high workload and limited resources. The objective of this study is to describe the sociodemographic, clinical, psychopathological, and psychosocial profile of adult frequent attenders (FAs) of PHC centres in Europe.

Methods: A systematic review with meta-analysis was carried out between September 2023 and August 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and consulting the PubMed, Embase, Scopus, Web of Science, and PsycINFO databases. From 1008 records, 17 studies were finally selected, with data extraction into content tables.

Results: FAs in PHC are typically middle-aged women with medium to high educational and socioeconomic levels, unemployed or retired, married, and living with their families. They often present chronic diseases and physical or psychological conditions, such as cardiovascular, respiratory, or locomotor issues. Depression, anxiety, and somatization are the most common psychological diagnoses. Psychosocially, they perceive their health as poorer, experience more social dysfunction, and report higher exposure to stress. The meta-analysis supports these findings but shows high heterogeneity (I² ≥ 50%) due to varying measurement tools and national contexts.

Conclusion: FAs in PHC are usually middle-aged women with medium-high socioeconomic status, retired or unemployed, and living with family. They often have chronic, physical, and some psychiatric conditions, with limited quantitative psychosocial assessment.