RT Journal Article SR Electronic T1 Grief symptoms and primary care use: a prospective study of family caregivers JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP bjgpopen20X101063 DO 10.3399/bjgpopen20X101063 A1 Mette Kjærgaard Nielsen A1 Kaj Christensen A1 Mette Asbjorn Neergaard A1 Pernille Envold Bidstrup A1 Mai-Britt Guldin YR 2020 UL http://bjgpopen.org/content/early/2020/06/08/bjgpopen20X101063.abstract AB Background Family caregivers to patients who are severely ill have high use of primary health care and psychotropic medication. However, it remains sparsely investigated whether healthcare services target the most vulnerable caregivers.Aim This study aimed to examine associations between family caregivers’ grief trajectories of persistent high-grief symptom level (high-grief trajectory) versus persistent low-grief symptom level (low-grief trajectory), as well as early contacts with GPs or psychologists and the use of psychotropic medication.Design & setting A population-based cohort study of family caregivers (n = 1735) in Denmark was undertaken.Method The Prolonged Grief-13 (PG-13) scale measured family caregivers’ grief symptoms at inclusion (during the patient's terminal illness), 6 months after bereavement, and 3 years after bereavement. Multinomial regression was used to analyse register-based information on GP consultations, psychologist sessions, and psychotropic medication prescriptions in the 6 months before inclusion.Results A total of 1447 (83.4%) family caregivers contacted their GP, and 91.6% of participants in the high-grief trajectory had GP contact. Compared with family caregivers in the low-grief trajectory, family caregivers in the high-grief trajectory had ≥4 face-to-face GP consultations (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.3 to 5.0), more GP talk therapy (OR =4.4; 95% CI = 1.9 to 10.0), and more psychotropic medication, but not significantly more psychologist sessions (OR = 1.7; 95% CI = 0.5 to 6.6).Conclusion Family caregivers in the high-grief trajectory had more contact with their GP, but their persisting grief symptoms suggest that primary care interventions for family caregivers should be optimised. Future research is warranted in such interventions and in the referral patterns to specialised mental health care.