Introduction:

The correct use of the International Classification of Primary Care (ICPC-2) allows adequate clinical practice and epidemiologic knowledge and the study of the community’s health.

Objective:

To identify ICPC-2 chapters’ Signs and Symptoms inadequately classified as active and chronic ones (CIC), their proportion, and the main chapters involved.

Methods:

An observational, cross-sectional, exploratory study was performed using data collected from consultations every Tuesday, Wednesday, and Friday during August of 2021, in the consultations of two general practice/family doctors in the Primary Care Health Unit of the Portuguese National Health Service. A descriptive analysis of the list of active problems of the users and recording of the classifications considered inappropriate was performed.

Results:

A population of 123 patients, 52.8% female, mean sample age of 53.3±22.4 years were studied. For 45.5% of the patients, there were chronic misclassifications, with CIC representing 8.2%. The musculoskeletal (16.3%), psychological (7.3%), and the female genital, circulatory, and general and nonspecific (all with 5.7%) chapters were the most frequent. There was no significant difference by gender and age, but the greater the number of total classifications, the greater the number of CIC.

Discussion:

The results may have a negative impact on patient follow-up, communication between physicians, and increased time spent in consultations, due to the lack of updating the list of problems and decreased credibility of records for investigation. The high prevalence of musculoskeletal signs and symptoms can lead to the resolution of these problems as chronic. The COVID-19 pandemic can be associated with a greater number of transient symptoms but is classified as CIC. Many active issues can affect appropriate classification.

Conclusion:

It is important to periodically update the list of problems, train family doctors in ICPC-2 use and frequently evaluate the classifications. Further validation studies of CIC in electronic record systems are needed.

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