1. Wonca European Conference, September 2005 1/12 CISPCISP CLUBCLUB Some studies using ICPC in European French-speaking countries Laurent Letrilliart, MD, PhD Wonca International Classification Committee

2. Wonca European Conference, September 2005 2/12 CISPCISP CLUBCLUB ICPC: a new epidemiological tool in the French-speaking countries Search in Medline database –Key word in Title/abstract: ‘ICPC’ 130 ‘ICPC’, and language=‘French’ 2 ‘CISP’ 2 –Relevant papers retrieved 3 Personal contacts –In France, Switzerland, and Belgium –Additional papers retrieved 5

3. Wonca European Conference, September 2005 3/12 CISPCISP CLUBCLUB Patients calling on doctors on duty (Humbert, Rev Prat Med Gen, 1999) Design and setting –Cross-sectional study –Community on call service, including 11 GPs from a French semi-rural area, 1992-3 Most frequent problems diagnosed (n = 979) –Stress (P02/16/74/75/76/77/99-D93) 21.0 % –Minor surgery (S18/54/56) 17.8 % –Digestive disorder (D73/87/88/98/99) 14.9 % –Respiratory disorder (R78/83/96/99) 9.0 %

4. Wonca European Conference, September 2005 4/12 CISPCISP CLUBCLUB Patients attending a polyclinic (Pult, Med Hyg, 1999) Design and setting –Cross-sectional study –General internal medicine polyclinic, Geneva university hospital, 1995 1.2 reasons for encounter per consult. (n= 2078) –Low back symptom/complaint (L03)8 % –Influenza (R80)7 % –Cough (R05)6 % –Headache (N01) 5 %

5. Wonca European Conference, September 2005 5/12 CISPCISP CLUBCLUB Reasons for encounter (n=2078 patients) 27% 22% 15% 11%

6. Wonca European Conference, September 2005 6/12 CISPCISP CLUBCLUB Patients referred to hospital (Letrilliart, Infect Control Hosp Epidemiol, 2001) Design and setting –Prospective cohort study –305 GPs from the French Sentinel system, 1997-9 1.5 problems per referral (n=7313) –Abdominal pain (D01)4.1 % –Trauma (A80)3.8 % –Heart failure (K77)3.6 % –Appendicitis (D88)2.8 %

7. Wonca European Conference, September 2005 7/12 CISPCISP CLUBCLUB 9% Reasons for referral (n=7313 patients) 21% 18% 14%

8. Wonca European Conference, September 2005 8/12 CISPCISP CLUBCLUB Homeless people in hostel (Le mauff, Rev Prat Med Gen, 2003) Design and setting –Cross-sectional study –Consultation by 2 GPs in 2 hostels for homeless people in Vendée (France), 2001-2 1.9 problems diagnosed per consult. (n=605) –Feeling anxious/nervous (P01) 5.6 % –Sleep disturbance (P06) 5.1 % –Social welfare problem (Z08) 4.0 % –Chronic alcohol abuse (P15) 3.9 %

9. Wonca European Conference, September 2005 9/12 CISPCISP CLUBCLUB Problems diagnosed (n=605 patients) 24% 13% 12% 11%

10. Wonca European Conference, September 2005 10/12 CISPCISP CLUBCLUB Primary care in jail (Feron, J Epidemiol Community Health, 2005) Design and setting –Retrospective cohort study –From a sample of 513 records (15 %) of discharged prisoners (Belgium), 2001-2 Most frequent problems (n=182 patient-years) –Drug misuse (P19) 22.1 % –Chronic alcohol misuse (P15) 4.8 % –Viral hepatitis (D72) 4.3 % –Asthma (R96) 3.9 %

11. Wonca European Conference, September 2005 11/12 CISPCISP CLUBCLUB 13% Reasons for encounter (n=182 patient-years) 14% 12% 22%

12. Wonca European Conference, September 2005 12/12 CISPCISP CLUBCLUB ICPC: a tool fitting the various features of primary care epidemiology Settings –Community, hospital, out-of-hours services –Specific populations (disadvantaged…) Fields –Somatic problems –Psychological or social problems Perspectives –Problems diagnosed, episodes of care –Reasons for contact, interventions