Objectives: 

The main goal of this project is to study current health care trajectories and predictors of an unfavourable course in patients visiting the General Practitioner (GP) with FD, by epidemiological analyses of detailed GP registry data. First we will quantify the prevalence of an unfavourable course of FD in primary care based on the number of encounters in an episode of care and the duration of an episode of care. Second we will describe the diagnostic behaviour of GPs in patients presenting with FD during the episodes of care, by quantifying the interventions registered by the GP (physical examination, referral, medication etc). Third we will study which factors (such as age, sex, SES, level of education, employment status, reason for encounter, comorbidity, medication use, etc.) predict an unfa-vourable course (a long duration of the episode of care) in patients visiting their GP for FD. Fourth we will develop and validate a prediction rule for an unfavour-able course of FD in primary care. All analyses will be repeated in data from Malta, after which differences will be related to results obtained by the cross-European survey on health care for FD.

Expected Results: 

1. Prevalence rates of an unfavourable course of FD in primary care
2. Diagnostic behaviour of GPs in patients presenting with FD
3. Predictors of an unfavourable course of FD in primary care
4. Prediction rule for predicting an unfavourable course in patients visiting their GP with FD
5. Replication of results in data from Malta, with differences related to health care for FD as assessed in a cross-European survey

Planned secondments and research visits: 

1. USUMA GmbH, Market and Social Research, Berlin, Germany (Dr. Schunter); Start: Month 14; Duration: 6 months; Aim: learn how to set-up and perform a cross-European survey
2. Mediterranean Institute of Primary Care (MIPC), Malta (Dr. Soler); Start: Month 26; Duration: 4 months; Aim: replicate analyses in registry data from Malta