All in the Family: Headaches and Abdominal Pain as Indicators for Consultation Patterns in Families

Mieke Cardol; Wil J.H.M. van den Bosch; Peter Spreeuwenberg; Peter P. Groenewegen; Liset van Dijk; Dinny H. de Bakker

doi:10.1370/afm.584

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Table 1.

Characteristics of the Study Population (N = 122,601)

Characteristic	Number or Mean
* Number of visits.
Families
Number	31,309
Mean number of family members (SD; range)	3.9 (1.1; 2–12)
Children
Number	65,671
Number with ≥ 1 consultation
Headache	966
Abdominal pain	1,802
Minor ailments	15,350
Chronic illnesses	7,668
Musculoskeletal trauma	3,055
Mean age, y (SD; range)	8.5 (4.9; 1–12)
Mean consultation frequency* per year (median; SD; range)	1.9 (2; 2.4; 0–43)
Girls, %	48.5
Parents
Number	56,930
Mean age, y (SD; range)	38.4 (6.3; 19–75)
Mean consultation frequency* per year (median; SD; range)	3.0 (2; 3.7; 0–75)
Women, %	53.9

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Table 2.

Percentage of Shared Variance in Consultation Frequency Between Families According to Consultation Diagnosis of at Least 1 Child, Corrected for Age, Sex, and Family Practice (N = 122,601)

	Consultation Diagnosis*
Family Members	Headache % (95% CI)	Abdominal Pain % (95% CI)	Minor Ailments % (95% CI)	Musculoskeletal Trauma % (95% CI)	Chronic Illness % (95% CI)	All Diagnoses^†%
Note: Shared variance = squared correlation between both family members at family level; 100% = maximum influence of shared factors at family level, 0% = no influence of shared family factors.
CI = confidence interval.
* The consultation diagnosis was headache for 4,173 families, abdominal pain for 7,414, minor ailments for 50,639, musculoskeletal trauma for 12,644, and chronic illness for 28,617.
† Based on our previous research on within-family similarity of contact frequencies in family practice.¹⁷
Mother-father	12.5 (9.4–16.0)	10.0 (7.8–12.3)	6.0 (5.3–6.7)	10.0 (8.4–11.9)	6.7 (5.8–7.7)	9.0
Mother-son	20.2 (16.4–24.1)	34.1 (31.0–37.1)	19.0 (18.0–20.0)	23.8 (21.5–26.1)	19.6 (18.2–21.1)	21.2
Mother-daughter	48.4 (44.5–52.3)	34.7 (31.7–37.7)	23.2 (22.1–24.3)	27.8 (25.4–30.1)	29.1 (27.6–30.6)	24.0
Father-son	4.7 (2.7–7.2)	17.1 (14.4–19.8)	8.8 (8.0–9.7)	11.2 (9.4–13.1)	6.6 (5.6–7.6)	10.2
Father-daughter	14.4 (11.1–18.1)	6.9 (5.1–8.9)	4.9 (4.3–5.6)	7.4 (5.9–9.0)	5.2 (4.3–6.1)	9.0
Daughter-son	27.6 (23.5–31.7)	26.4 (23.4–29.4)	15.1 (14.1–16.1)	23.5 (21.3–25.8)	18.1 (16.8–19.5)	23.0

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Table 3.

Correlations of Diagnoses in the Study Year, Within Families (Individual Level) and Between Families (Family Level) (N = 122,601)

	Abdominal	Minor	Musculoskeletal	Chronic
Level	Pain r	Ailments r	Trauma r	Illness r
Individual level
Headache	0.07	0.04	0.04	0.11
Abdominal pain	—	0.06	0.03	0.05
Minor ailments	—	—	0.04	0.07
Musculoskeletal trauma	—	—	—	0.02
Family level
Headache	0.38	0.28	0.18	0.47
Abdominal pain	—	0.43	0.18	0.23
Minor ailments	—	—	0.14	0.19
Musculoskeletal trauma	—	—	—	0.04

Additional Files

Tables

Supplemental Table

Supplemental Table. Estimates and Multilevel Poisson Model (Allowing Extra Dispersion at the Individual Level) With 3 Levels, Underlying Table 2, Based on the Corrected (for All Other Parameters in the Model) Variance and Covariance Estimates

Files in this Data Supplement:

Supplemental data: Table - PDF file, 1 page, 86 KB
The Article in Brief

All in the Family: Headaches and Abdominal Pain as Indicators for Consultation Patterns in Families

By Mieke Cardol, PhD, and colleagues

Background This study explores patterns of doctor visits within families. In particular, it looks at whether families have patterns of visits for minor conditions, such as headache or abdominal pain.

What This Study Found Families have shared patterns of doctor visits for headaches and abdominal pain. This clustering of symptoms is most common in mothers and children, particularly daughters.

Implications

Understanding patients' family context can help primary care doctors better diagnose and care for them. It may also help patients identify and act on patterns of seeking care that are not useful.
The decision to visit the family doctor for headache or abdominal pain is influenced by behavior in one's family.