What our study revealed about list users. Our results show that those who made use of a list were older than the ones who did not, more likely to be pensioners, and less likely to be employed or be housewives. They had more chronic diseases, were receiving more medications including benzodiazepines, and had a significantly higher rate of medical appointments than did the controls. Psychiatric diagnoses were no more common among the list users, and reasons given for list use were congruent with aging and an increased burden of disease and medication. We could not discern the exact contribution of each independent factor of advanced age or disease burden. This would be an interesting issue to address in more elaborate research, as would be the actual frequency of list use.
Limitations of our study. The weaknesses of our study include its questionable generalizability and the possibility that a number of list bearers may not have been recruited due to time constraints on patients or physicians. Randomization could have been improved if we had selected the controls consecutively after selecting the study patients, and not at a separate time. We did not time the length of the consultations, something that should be done in future studies.
The fact that the study group consumed more benzodiazepine medications may hint that its members suffer from greater levels of anxiety or depression. Nevertheless, we assumed that such conditions were likely of modest intensity since they were not included in the medical records.
Large-scale research could yield far more trustworthy results by adjusting for age, country of origin, and disease burden.
CORRESPONDENCE
Sody Naimer, MD, Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva 84105, Israel; sodyna@clalit.org.il
Acknowledgement
The authors thank Dr. Joseph Herman and Mrs. Barbra Schipper for their assistance in preparing this manuscript.