MUS of Chinese Patients presenting to Primary Care

Abstract

BACKGROUND: It is a common belief in the Chinese culture that symptoms are always indications of diseases and should always be treated early. People who have medically unexplained symptoms (MUS) may become more and more worried as no cause can be found despite repeated doctor consultations, various investigations and different treatments. The increased anxiety in tum may put more stress on the mind and body, resulting in a vicious cycle of more physical symptoms. The aim of this study is to find out how common and what the common MUS are among Chinese patients presenting to primary care in Hong Kong so that we can be prepared to manage these patients better. METHODS: The diagnoses by ICPC-2 codes of all consultations from 1993 to 2003 of an academic primary care family medicine clinic serving a patient population of 8000 in Hong Kong were analysed to identify the rates and types of MUS presented to the clinic. MUS was defined as a diagnosis coded by an ICPC-2 code for symptom. The ICPC-2 codes were analysed by individual symptoms, systems and patient demographics. RESULTS: 1319 (19.5%) of 6766 patients who had consulted had at least one MUPS, and 47549 (18.1%) of a total of 262004 ICPC-2 diagnoses were MUS. The annual rates varied from 15.5 % in 1995 to 20.8% in 1999. The top five MUS were cough, dyspepsia, stomach pain, abnormal sensation of eyes and knee pain. The musculoskeletal system had the most MUS. There was no significant difference between the age and sex distribution of MUPS and non MUPS consultations. CONCLUSION: MUS were common among Chinese patients from all age-sex groups and made up one fifth of the workload in primary care.