Introduction:The CanMEDS framework, originally developed for postgraduate training, has also been adopted in undergraduate medical education. Evaluating how well undergraduate training prepares graduates for clinical work is one way to assess its success. Materials and methods:This study examined how Finnish doctors perceive the correspondence between their undergraduate education and their current work, and how the teaching of CanMEDS roles and other factors are associated with these evaluations. Data came from the Finnish nationwide Physician 2023 survey (response rate 49%). Of the 4882 respondents, 1240 had graduated between 2014 and 2023 and comprised the study group. Respondents assessed satisfaction with hospital and health centre training and with the teaching of the seven CanMEDS roles. Binary logistic regression was used to examine associations with perceived correspondence between undergraduate education and current work. Results:About 45% of respondents reported that their education corresponded well to their work. Nearly 80% were satisfied with hospital training, while only slightly more than half were satisfied with health centre training. The regression model explained 30% (Nagelkerke R 2) of the variance in perceived correspondence, with a correct classification rate of 71%. Teaching of Medical knowledge (OR = 3.70, 95% CI [2.35-5.84]) showed the strongest association. Communication skills, Health Advocacy, and Leadership and Management skills were not significantly associated with perceived preparedness. Conclusions:Finnish doctors' perceptions of undergraduate education aligning with work were strongly linked to the teaching of medical knowledge and lifelong learning. Hospital training contributed more to perceived preparedness than health centre training. Several CanMEDS roles showed limited association with preparedness.

Työkyvyn tuesta hyötyvien henkilöiden tunnistaminen sekä yksilöllisesti suunnattujen työkyvyn tukitoimien kehittäminen ovat ajankohtaisia työvoiman riittävyyden turvaamiseksi. Tutkimuksen tavoitteena oli tuottaa tietoa siitä, miten potilaat kokivat toimijuutensa perusterveydenhuollossa toteutetussa työkykykoordinaattoripalvelussa. Euroopan sosiaalirahaston rahoittamassa TYKYTUOhankkeessa toteutettiin kahden kunnan perusterveydenhuollossa merkintäkäytäntö, jossa hoitajat ja lääkärit havainnoivat sekä kirjasivat vastaanotolla, liittyikö työikäisten potilaiden käynnin syy työhön tai oliko heillä työkyvyn tuen tarvetta. Perusterveydenhuoltoon palkatut työkykykoordinaattorit kontaktoivat merkinnän saaneet potilaat ja tarjosivat heille mahdollisuutta tulla vastaanotolleen. Tutkimuksessa haastateltiin työkykykoordinaattorin tavanneita potilaita (n=10) kahdesti: ensimmäisen työkykykoordinaattoritapaamisen jälkeen ja noin puoli vuotta ensimmäisestä tapaamisesta. Induktiivisella sisällönanalyysilla aineistosta löydettiin kaksi yläluokkaa ja neljä alaluokkaa. Yläluokat jakautuivat potilaiden yksilölliseen kokemukseen rakenteiden luomasta passiivisuudesta sekä potilaiden kokemukseen autonomisuudesta. Potilaiden kokemukset toimijuudesta ja osallisuudesta vahvistuivat työkykykoordinaattoripalvelun myötä. Työkykykoordinaattoripalvelun koettiin myös toimineen merkittävänä toimintamallina yksilöllisten ja asiakaslähtöisten työkyvyn tukitoimien toteutumisessa. Tulosten perusteella työkykykoordinaattoripalvelulla olisi paikkansa osana työikäisten palvelukokonaisuutta perusterveydenhuollossa yhdenvertaisten työkyvyn tuen palvelujen saatavuuden turvaamiseksi ja potilaiden toimijuuden kokemuksen vahvistamiseksi.

INTRODUCTION:Numerous published case reports have described retained drug needle fragments in soft tissue as causes of localised pain and infections in persons who inject drugs (PWIDs). Furthermore, there are case reports of PWIDs with lung and heart embolisations caused by needle emboli. Subcutaneously retained needles also pose a risk of needlestick injury to medical staff. There are no previous epidemiological attempts to evaluate how common X-ray-confirmed retained drug needle fragments are among community-dwelling PWIDs. Due to the unclear clinical relevance of needle fragment retentions, there is a need to systematically evaluate the prevalence of retained needles, related complications and risk factors predisposing needle fragmentations. METHODS AND ANALYSIS:We have planned a prospective cross-sectional study covering multiple ambulatory clinics that manage PWIDs in Tampere, Finland. PWIDs will be asked to give their written informed consent prior to any study procedures. Initially, we aim to recruit a sample for a pilot study of 20 adults (≥18 years) who will be asked to fill out a questionnaire related to their drug use history and their suspicions of having retained needle fragments. Subsequently, participants will undergo X-ray imaging of the injection sites as part of the study. Female participants of childbearing age (<50 years) will undergo urine sample pregnancy testing prior to X-ray imaging. If a needle fragment is found, the participant will be referred to a tertiary centre for consultation at their individual discretion. After the pilot study, we aim to recruit 80 more adult participants. ETHICS AND DISSEMINATION:We submitted the study protocol for ethics review to the Tampere University Hospital Ethics Committee and received their favourable opinion (study code: R22037). We subsequently sought organisational permission from the clinics to conduct the study. To be enrolled, PWIDs must provide written informed consent. The study results will be published in international peer-reviewed journals and conference proceedings. TRIAL REGISTRATION NUMBER:NCT05679284.

Argumentative Delphi-method as a research method for occupational health care’s future –collaboration with other health care sectors and workplaces in 2030 We investigated how occupational, public, and primary health care, and working life experts perceive the role of occupational health care and its cooperation with health care sectors and workplaces in 2030 using the argumentative Delphi method. We formulated six scenarios from three Delphi-rounds: Enhanced cooperation in work ability issues, Lack of resources encourages communication, Work ability support services deteriorate, Work ability collaboration is part of leadership in workplaces, Work ability collaboration remains unchanged and Markets steer work ability collaboration. Scenarios indicate that occupational health care will be essential in Finland’s healthcare in the future, but it must adapt to a transforming working life. The study confirmed that morphological analysis framework can support the argumentative delphi method.

Objective:Learning in the clinical environment is crucial for students to enhance practical skills. However, due to the variability of clinical settings, providing consistent teaching and sufficient patient cases can be challenging. As a result, the perceived quality of rotations often varies. Previous studies have reported mixed findings on whether teaching quality or patient encounters influence students' perceptions of rotation quality or exam performance. Additionally, previous studies have often focused on structured teaching in clinical settings. We aimed to explore how students' evaluations of clinical teaching outside structured learning events during rotations impact the perceived achievement of learning goals. Methods:We analysed student evaluations from paediatric and gynaecology rotations at Tampere University Medical School during the 2021-2022 academic year. Evaluations covered clinical teaching quality, opportunities to examine patients, and perform procedures. A linear regression model was used to assess the influence of these factors on the perceived achievement of learning goals, with the statement "I achieved the given learning goals" as the dependent variable. Results:A total of 140 students evaluated the paediatric and 142 the gynaecology rotations, providing 833 and 1188 evaluations, respectively. All questions received mean scores above 5 on a 7-point scale. The mean for achieving learning goals was 5.6 for paediatrics and 5.7 for gynaecology. All independent variables showed significant associations with the dependent variable, with "The use of time was meaningful" having the greatest impact. Conclusion:Students generally reported successfully achieving their learning goals in both rotations. Notably, the perceived meaningful use of time had the greatest impact on the perceived achievement of learning outcomes.

INTRODUCTION:Clinical-phase learning is integral to medical education, increasingly challenged by a rising student population. Prior research has presented conflicting findings on students' preferences for following doctors at different stages of their career. Moreover, evaluations of clerkships across specialties vary significantly. This study explored medical students' perceptions about who they received the best clinical teaching from and why. METHODS:A survey was conducted among 4th- to 6th-year medical students at Tampere University, Finland. Information was sought from participants on aspects regarding from whom and where they believed they received the best clinical teaching: doctors' properties (age group and career stage) and setting (field of specialty and location). Open-ended responses were analysed using inductive content analysis. RESULTS:We obtained 262 responses, yielding an overall response rate of 62%. Predominantly, respondents favoured resident doctors (54%), young doctors aged 25-34 years (41%), university hospitals (34%) and the field of internal medicine (25%). Common reasons cited included instructors dedicating time for teaching, enthusiasm about teaching and attentiveness to students. However, over half of the themes were related to specific answer options. CONCLUSIONS:Our findings indicate that Finnish medical students most commonly prefer to receive clinical teaching from residents and young doctors. Nevertheless, exposure to doctors at their different career stages and in various settings is perceived as valuable. To enhance clinical teaching, organisations should allocate adequate time and encourage doctors to engage actively with students, understanding their individual learning needs and fostering independent participation.

AIMS:This study aimed to investigate occupational health (OH) primary-care patients' use of other health-care services and whether parallel use affects their likelihood to have sickness absences (SA) or disability pensions (DP).METHODS:Primary-care services in Finland are provided through three parallel health-care sectors, all available to the working population: public, private and OH sectors. Patients may also be referred to secondary care. This follow-up study combines real-world medical record data containing SA data from a nationwide OH provider with health-care attendance data from public and private primary-care sectors and public secondary care, sociodemographic data and DP decisions. Patients between 18 and 68 years of age who used OH primary care at least once during the study years 2014-2016 were included. The total study population comprised 59,650 patients. Odds ratios were used to analyse association between parallel service use and SA or DP.RESULTS:Females and patients with a lower educational level were more likely to use services in other health-care sectors in addition to OH than others. Those patients who used any other health-care sector in addition to OH primary care had an increased likelihood of having long SA or receiving DP.CONCLUSIONS:OH primary-care patients using the services of several health-care sectors in parallel have an increased likelihood of receiving disability benefits - either SA or DP. There is need for care coordination to ensure adequate measures for work-ability support.

BACKGROUND:Previous research has shown that the Swedish speaking minority in Finland has slightly but significantly better health compared with the Finnish speaking majority. However, a clear explanation for this is lacking. AIM:The aim of the study was to explore differences of perceived health comparing three groups: Swedish speakers with reported dominance of Swedish also in the preceding generation; contemporary Finnish speakers with reported dominance of Finnish in the preceding generation and a group with a reported mixed-language structure of Finnish and Swedish between generations. INDIVIDUALS AND METHODS:Health and Social Support is an on-going population-based survey initiated in 1998 (N = 64,797), aimed at working-age adults. The present study is based on the 2012 follow-up survey, which included a question on the dominating language (Swedish or Finnish) of the respondents and their parents. The outcome was perceived health, which in this study was dichotomized to very good/good and intermediate/poor/very poor. The statistical analysis was carried with logistic regression, using SAS software. Age, gender and occupational training were included as covariates in the multivariable analysis. RESULTS:This study found that the Swedish-speaking group in Finland report better perceived health compared with the Finnish-speaking group (odds ratio 1.28, 95% confidence interval 1.04-1.57, p < 0.001). The health of the mixed language-speaking group fell between the other two groups. CONCLUSIONS:The results gave some support to a culturally mediated mechanism for the health advantage of Swedish speakers. Cultural features of Swedish-speaking groups in Finland may also support health promotion of the Finnish-speaking majority.

Background Every physician has a unique professional identity. However, little is known about the diversity of identities among physicians. This study aimed to quantitatively assess the professional identity of physicians in Finland using descriptions of professional identity. Methods This study was part of a larger cross-sectional Finnish Physician 2018 Study. The target population consisted of all Finnish physicians under the age of 70 ( N = 24,827) in 2018. The sample was drawn from physicians born on even numbered days ( N = 11,336) using the Finnish Medical Association register. A total of 5,187 (46%) physicians responded. Professional identity was examined by 27 given characterisations using a five-point Likert scale. Multivariate logistic regression was used in assessing how place of work, graduation year and gender were associated with identity descriptions. Results The descriptions which most physicians identified with were “member of a working group/team” (82%), “helper” (82%), and “health expert” (79%); the majority reported these as describing them very or quite well. Identity descriptions such as “prescriber of medications” (68% vs. 45%), “prioritiser” (57% vs. 35%) and “someone issuing certificates” (52% vs. 32%) were more popular among junior than senior physicians. The biggest differences between the genders were found in the descriptions “provider of comfort” (62% vs. 40%) and “someone engaged in social work” (45% vs. 25%), with which women identified more frequently than men. Conclusions Strong identification as a member of a team is an important finding in the increasingly multiprofessional world of health care. Importantly, most physicians shared several core professional identity descriptions (i.e., helper, health expert) that reflect the traditional image of an exemplary doctor.

Adherence to inhaled corticosteroids (ICS) has been described as poor. In adherence studies, if the actual prescribed dosing is not available, generic defined daily doses (DDD) are applied instead when assessing adherence. We evaluated asthma patients' adherence in a large prospective follow-up survey. We also analysed whether World Health Organization (WHO) and Global Initiative for Asthma (GINA) reference doses give different results. The current study was cross-sectional and included respondents attending to HeSSup follow-up questionnaire in 2012. Altogether 1,141 of 12,854 adult participants answered positively to the question about having asthma. According to the Finnish Social Insurance Institutions' medication register, 686 of them had purchased ICS medication during 2011. DDDs for ICS by WHO as well as medium doses from GINA report were used as reference doses to evaluate adherence. To estimate adherence to ICS, the proportion of days covered (PDC) over one year was calculated for every patient. If the lower limit of GINA medium ICS dose was used as a reference, 65% of the patients were adherent (PDC ≥ 80%). Use of WHO's DDD as reference halved the proportion of adherent patients. Adherence was higher among those using a combination inhaler of corticosteroid and long-acting β2-agonist compared to those using steroid only inhalers. Use of WHO's daily defined doses as reference values may lead to underestimation of adherence to inhaled corticosteroids. Thus, attention should be paid when choosing the reference doses for the evaluation of adherence to inhaled corticosteroids in asthma.

OBJECTIVE:To illustrate the views of chief physicians in Finnish primary healthcare health centres (HCs) on the existing research capacity of their centres, their attitudes to practice-based research network activity, and research topics of interest to them. DESIGN:A cross-sectional survey study. SETTING:Finnish HCs. SUBJECTS:Chief physicians in Finnish HCs. MAIN OUTCOME MEASURES:We used a questionnaire that included five-point Likert scales and multiple choice and open-ended questions to identify the chief physician's profile, the HC content, the attitudes of chief physicians towards engagement in research, research topics of interest to them, and factors that may influence their motivation. Descriptive methods were used for the analysis of the quantitative data, while the qualitative data were processed using inductive thematic analysis. RESULTS:There was a relatively good representation of all hospital districts. One-third of HCs had at least one person doing research, and 61% of chief physicians would support research in their setting. Their stimulus for research was primarily testing new therapies, protocols, and care processes, as well as effectiveness and healthcare improvement. The expected benefits that motivate engagement in Practice-based research networks (PBRNs) are evidence-based practice and raised professional capacity and profile of the HC. CONCLUSIONS:Chief physicians regard research as an elementary part of the development of primary care practices and health policy. Their motivation to engage in PBRN activity is determined by the relevance of the research to their interests and the management of competing priorities and resource limitations.

Background: The prevalence of mental disorders is increased among people of low socioeconomic status or educational level, but it remains unclear whether their access to treatment matches their increased need. Aims: Our objective was to examine whether educational level as an indicator of socioeconomic status is associated with use of mental health services, psychotropic medication and psychotherapy in Finland. Method: Cross-sectional data from a follow-up survey of a longitudinal, population-based cohort study were used to form a sample of 3,053 men and women aged 24 to 68 with a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, mental health service use and educational level were assessed with self-report questionnaire. Educational level was determined by the highest educational attainment and grouped into three levels: high, intermediate and low. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates in the fully adjusted model were age, gender and number of somatic diseases. Results: Compared to high educational level, low educational level was associated with higher odds of using antidepressants (OR 1.35, 95% CI [1.09, 1.66]), hypnotics (OR 1.33, 95% CI [1.07, 1.66]) and sedatives (OR 2.17, 95% CI [1.69, 2.78]), and lower odds of using mental health services (OR 0.80, 95% CI [0.65, 0.98]). No associations were found between educational level and use of psychotherapy. Conclusions: The results do not suggest a general socioeconomic status related mismatch. A pharmacological emphasis was observed in the treatment of low educational background participants, whereas overall mental health service use was emphasized among high educational background participants.

Background Continuity of care constitutes the basis of primary health care services and is associated with decreased hospitalization. In Finland, accessibility to primary care and increased use of hospital services are recognized challenges for the health care system. Objectives The aim of the study was to determine whether having a named GP is associated with hospital service use. Methods The data are part of the Health and Social Support study (HeSSup) based on a random Finnish working-age population sample. The cohort of the study comprised participants of postal surveys in 1998 ( n = 25,898) who returned follow-up questionnaires both in 2003 and 2012 ( n = 11,924). Background characteristics were inquired in the questionnaires, and hospitalization was derived from national registries (Hilmo-register). Results A named GP was reported both in 2003 and 2012 only by 34.3% of the participants. The association between hospital days and a named GP was linearly rising and statistically significant in a single predictor model. The strongest associations with hospital use were with health-related factors, and the association with a named GP was no longer significant in multinomial analysis. Conclusion A named GP is associated with an increased use of hospital days, but in a multinomial analysis the association disappeared. Health related factors showed the strongest association with hospital days. From the perspective of the on-going Finnish health and social services reform, continuity of care should be emphasized.

Objectives: The study aimed to find whether Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) predicts the severity of fibromyalgia symptoms after one year in patients with fibromyalgia. The second aim of the study was to observe how symptoms evolved during a one-year follow-up. Design: Prospective cohort and observational study. Five questionnaires were sent to patients. The same questionnaires (excluding OMPSQ) were sent after one year. The patients were allocated into two cohorts using the results of OMPSQ. Other variables were analyzed and observed separately. Setting: Primary healthcare center in the city of Nokia, Pirkanmaa, Finland Subjects: Patients with fibromyalgia were included in the study after a physician's examination and confirmation of diagnosis with the assistance of the American College of Rheumatology (ACR) 2010 criteria. Main outcome measures: Fibromyalgia impact questionnaire (FIQ) scores Results: The FIQ scores increased slightly in both OMPSQ-cohorts with no statistically significant differences. The patients mostly reported that the symptoms were unchanged or got worse when asked separately from other questionnaires. There was a statistically significant decrease in PHQ-9 score in depressed patients who received antidepressants and/or psychological therapy. In addition, FIQ scores also decreased in depressed patients. Patients who received alterations to the treatment plan reported positive changes in the symptoms more often. Conclusion: With these results, we cannot conclude that OMPSQ predicts the patient's severity of symptoms. On the contrary, we can conclude that antidepressants and/or psychological therapy might reduce fibromyalgia symptoms for depressed patients with fibromyalgia. Patients with fibromyalgia might benefit from clinical evaluation and modifications to the treatment plan if necessary.

Objectives To investigate occupational health frequent attenders’ (FAs) use of other healthcare sector services and whether parallel use affects their likelihood to receive a disability pension. Design Longitudinal study combining routine medical record data with register data. Setting Primary care in Finland is provided through three parallel healthcare sectors, all available to the working population. Additionally, patients can be referred to secondary care. This study combines medical record data from a nationwide occupational healthcare provider, with healthcare attendance data from private care and from public primary and secondary care attendance, sociodemographic data and disability pension decisions. Participants Patients between 18 and 68 years of age who used occupational health primary care at least once during the study years 2014–2016 were included. The total study population was 59 650 patients. They were divided into three groups (occasional and persistent FAs and non-FAs) for analysis. Primary and secondary outcome measures The primary outcome was FAs parallel use of private care and public primary and secondary care. The secondary outcome was work disability pension granted to FAs who used several healthcare sectors. Results Both FA groups were more likely to use other healthcare service sectors more than non-FAs did. Persistent FAs were likely to use public secondary care services in particular (OR 4.31 95% CI 3.46 to 5.36). FAs using all healthcare sectors were also more likely to receive a disability pension than those FAs using only occupational health services (OR 4.53 (95% CI 1.54 to 13.34). This association was strengthened by attendance in public secondary care. Conclusions FAs using several healthcare sectors in parallel have an increased likelihood to receive a disability pension. There is need for care coordination to ensure adequate measures for work ability support.

Background Migraine has been associated with several diseases. This population-based prospective Finnish postal survey Health and Social Support Study explored whether self-reported migraine predicted incident hypertension independently in a working-age population by utilizing two data sources: the baseline survey from the year 1998 in combination with the follow-up survey data from the years 2003 and 2012 with linkage to the national Social Insurance Institution registry data of the special reimbursement medication for hypertension from 1999 to 2013. The survey follow-up reached until the second follow-up in the year 2012. The register follow-up also included the year 2013. Methods The present population-based prospective cohort study, utilizing two different data sources, included 8593 respondents (22.7% response rate) who participated in 1998, 2003, and 2012 but who did not report hypertension at the baseline in 1998, and whose responses could be linked with the Social Insurance Institution registry data from the beginning of 1999 to the end of 2013. The multivariable logistic regression analysis was based on the combined two data sets. Results A significant association of self-reported migraine and incident hypertension (odds ratio 1.37; 95% confidence interval 1.20-1.57) prevailed in the multiple logistic regression analysis adjusted for central socio-demographic and health behaviour variables. Conclusion Extra attention should be paid to prevention and control of hypertension in working-age migraine patients.

Abstract Background Continuity of care strengthens health promotion and decreases mortality, although the mechanisms of these effects are still unclear. In recent decades, continuity of care and accessibility of health care services have both decreased in Finland. Objectives The aim of the study was to investigate whether a named and assigned GP representing continuity of care is associated with the use of primary and hospital health care services and to create knowledge on the state of continuity of care in a changing health care system in Finland. Methods The data are part of the Health and Social Support (HeSSup) mail survey based on a random Finnish working age population sample of 64,797 individuals drawn in 1998 and follow-up surveys in 2003 and 2012. The response rate in 1998 was 40% (n = 25,898). Continuity of care was derived from the 2003 and 2012 data sets, other variables from the 2012 survey (n = 11,924). The principal outcome variables were primary health care and hospital service use reported by participants. The association of the explanatory variables (gender, age, education, reported chronic diseases, health status, smoking, obesity, NYHA class of any functional limitation, depressive mood and continuity of care) with the outcome variables was analysed by binomial logistic regression analysis. Results A named and assigned GP was independently and significantly associated with more frequent use of primary and hospital care in the adjusted logistic regression analysis (ORs 1.53 (95% CI 1.35–1.72) and 1.19 (95% CI 1.08–1.32), p < 0.001). Conclusion A named GPs is associated with an increased use of primary care and hospital services. A named GP assures access to health care services especially to the chronically ill population. The results depict the state of continuity of care in Finland. All benefits of continuity of care are not enabled although it still assures treatment of population in the most vulnerable position.

Background The aim of our study was to evaluate the risk for comorbid cardio- and cerebrovascular diseases in the working-aged migraine population of Finland. Methods A total of 1505 cases who reported diagnosed migraine and 3010 controls from a cohort of 11,596 cases in the Finnish Health and Social Support Study were included. The study material was linked with two registers. ICD diagnoses I63 for ischemic stroke (IS), I21 − I22 for acute myocardial infarction (AMI), and G43 for transient ischemic attack (TIA) among study participants were drawn from the national Finnish Care Register for Health Care at the follow-up in 2012. Reimbursed triptan prescriptions were drawn from the national Social Security Institution (SII) data. The self-reported vascular risk factors were hypertension, high cholesterol values, any diabetes, myocardial infarction, stroke, and TIA. Odds Ratios (OR) with 95% confidence (95% CI) intervals were assessed for diagnosed stroke, myocardial infarction, and TIA. Results Migraineurs were mostly female (82%) and ≥ 54 years old (62%). Triptans were reimbursed among 34.7% of migraineurs. A self-reported hypertension (21%), high serum cholesterol (38%), and any diabetes (7%) were more common among migraineurs vs controls ( p < 0.05). There was no risk for AMI. The risk for TIA (OR 3.20, 95% CI 1.45–7.05) and IS (2.57, 95% CI 1.28–5.17) among migraineurs vs controls remained high after adjustment for self-reported hypertension, obesity, and smoking. The risk was higher among women in two groups ≥54 years (3.25, 95% CI 1.35–7.84 and 5.0, 95% CI 1.94–12.89, respectively). The average age for IS in migraine was 57.5 years and for TIA 58.2 years among women, and 52.8 years and 50.3 years among men, respectively. Conclusion Cardiovascular risk should be screened in the aging migraine population, and hormonal and other migraine-related risk factors should be considered, especially among women. Efficacious attack treatment with triptans should be offered to migraine patients who do not show contraindications.

Background Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. Methods This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. Results In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. Conclusions Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.