Symptom diagnoses in primary care: Which symptoms persist?

Background Symptom diagnoses are common in general practice. While most of the patients have symptoms that improve quickly, some of them may develop persistent symptoms. This may cause a burden for the patient and the doctor. We aimed to explore the prevalence of persistent and transient symptoms in primary care. Methods This is a a retrospective cohort study in a Dutch practice-based research network (Family Medicine Network) with 28,590 registered patients. We included all patients who visited their GP in 2018 with symptom diagnoses according to the International Classification of Primary Care (ICPC-2; codes 1-29). An Episode of Care (EoC) is defined as 'a health problem in an individual from the first until the last encounter with a health care provider'. We established for each symptom diagnosis the duration of the EoC Results In total, 14,989 patients visited their GP in 2018 with symptom diagnoses. Based on the distribution of the duration of the EoC of symptom diagnoses, we distinguished 4 symptom diagnoses duration groups: mild [1 day], moderate |2 to 10 days], long [11 to 162 days] and persistent [more than 162 days]. 3906 (26.0%) patients had one or more persistent symptom diagnoses. Psychological symptoms had the highest proportion of patients with persistent symptom diagnoses (43.9%) compared to all other types of persistent symptoms (18.4%; range; 7,3% - 23.7%). Conclusion Most physical symptom diagnoses were transient. The highest proportion of patients with persistent symptom diagnoses had psychological symptoms. More research is needed to explore why symptoms may evolve into persistent symptoms.