Diabetes, coronary heart disease, chronic obstructive pulmonary disease (COPD), and asthma are long-term medical conditions that often have patients going in and out of urgent care. Patients suffering from any of these diseases must consistently interrupt their daily lives with visits to doctors, and deal with high medical expenses. Claire Blakeley from the Department of Psychiatry at Manchester Mental Health and Social Care Trust currently works in a stroke rehabilitation clinic and was curious if high-levels of anxiety contributed to these patients coming into the hospital. Led by Blakeley, a study published online in the Journal of Psychosomatic Research examined 28,823 individuals with one of the aforementioned long-term diseases and assessed if anxiety could have played a role in their visit to urgent care.

Looking Back on Past Studies

Past studies have verified that depression, a common comorbid disorder to anxiety, does, indeed, increase the use of urgent care in patients with long-term medical conditions by as much as 50%. In a similar setup to this study, Blakeley reviewed past papers on urgent care visits that met the following criteria:

  • Included adults over 18 with diabetes type 1 or 2, acute or chronic COPD, acute or chronic asthma, and coronary heart disease.
  • Used a prospective cohort design.
  • Included a standardized measure of anxiety.
  • Assessed urgent care facilities and protocol prospectively.

Blakeley and her team periodically searched for new studies between 2008 and 2013. Regardless of date or language, Blakeley reviewed eight studies focusing on COPD, coronary heart disease, and asthma. Studies on diabetes and urgent care have yet to be done. After qualifying, the authors were contacted for any additional information that was not published.

Anxiety is Not a Risk Factor for Urgent Care Use

Out of all eight studies, only one showed significant effects of anxiety on the use of urgent care. “On combining univariate findings from eight independent studies, anxiety was not significantly associated with increased use of urgent healthcare," writes Blakeley. In review of this study, Blakeley notes, “A possible explanation for the 'lack of effect' of anxiety on urgent care may be that it is difficult to disentangle the impact of anxiety on healthcare use from the effects of co-morbid depressive symptoms."

Date of original publication: .

Updated on October 23, 2015.


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Claire Blakeley, Amy Blakemore, Cheryl Hunter, Else Guthrie, Barbara Tomenson, Chris Dickens. Does anxiety predict the use of urgent care by people with long term conditions? A systematic review with meta-analysis. Journal of Psychosomatic Research, September 2014; DOI: 10.1016/j.jpsychores.2014.06.010