Social Isolation Predicts Frequent Attendance in Primary Care

Tegan Cruwys (Lead / Corresponding author), Juliet R. H. Wakefield, Fabio Sani, Genevieve A. Dingle, Jolanda Jetten

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Background: Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their healthcare. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks).

Methods: Study 1 (N=1752) was a large cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N=46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance.

Results: All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness.

Conclusions: Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services.
Original languageEnglish
Pages (from-to)817-829
Number of pages13
JournalAnnals of Behavioral Medicine
Issue number10
Early online date3 Feb 2018
Publication statusPublished - Oct 2018


  • family practice
  • mental health
  • somatization
  • social identity
  • frequent attenders
  • health services research
  • multiple group membership


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