Psychosocial Correlates, Psychological Distress, and Quality of Life in Patients with Medically Unexplained Symptoms: A Primary Care Study in Karachi, Pakistan

2014 ◽  
Vol 48 (4) ◽  
pp. 235-251 ◽  
Author(s):  
M. I. Husain ◽  
N. Chaudhry ◽  
J. Morris ◽  
S. N. Zafar ◽  
F. Jaffery ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Psychological Distress ◽  
Medically Unexplained Symptoms ◽  
Psychosocial Correlates ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Care Study

A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms

2006 ◽  
Vol 37 (2) ◽  
pp. 283-294 ◽  
Author(s):  
JOSÉ M. AIARZAGUENA ◽  
GONZALO GRANDES ◽  
IDOIA GAMINDE ◽  
AGUSTÍN SALAZAR ◽  
ÁLVARO SÁNCHEZ ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Medically Unexplained Symptoms ◽  
Randomized Controlled ◽  
Communication Techniques ◽  
Utility Index ◽  
Sf 36 ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background. Somatizing patients are a challenge to general practitioners (GPs). A cluster randomized controlled trial was conducted to asses the effect of specific communication techniques delivered by GPs on somatizing patients' self-perceived health.Method. Thirty-nine GPs were assigned randomly to two parallel groups. GPs in the intervention group treated somatic patients according to specific communication techniques focused on offering a physical explanation – release of hormones – and approaching sensitive topics in the patient's experience indirectly. Control GPs used the standard Goldberg reattribution technique. A total of 156 patients, aged 18–65 years, were selected randomly from a list of 468 patients with six or more active symptoms for women and four or more for men. All patients had six programmed 30-min consultations. Health-related quality of life (assessed with the 36-item Short-Form Health Survey, SF-36) and a summary utility index were used as outcome measures. Patients were interviewed at home at baseline and at 3, 8 and 12 months after the beginning of the intervention.Results. Patients in both groups improved in all dimensions of the SF-36. The time course of the quality of life was significantly better for the intervention group in five of the eight scales of the SF-36 (bodily pain, mental health, physical functioning, vitality, and social functioning) and in the utility index (p<0·039).Conclusions. Communication techniques were found to have a clinically relevant impact on body pain. This finding, together with a trend towards better scores in the remaining scales, justifies the use of these techniques in psychosocial interventions delivered to patients with medically unexplained symptoms.

scholarly journals Novel primary care treatment package for patients with medically unexplained symptoms: a cohort intervention study

BJGP Open ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. bjgpopen17X101121
Author(s):  
Frank Röhricht ◽  
Ivan Zammit ◽  
Nina Papadopoulos
Keyword(s):  
Primary Care ◽  
Somatic Symptom ◽  
Medically Unexplained Symptoms ◽  
Service Utilisation ◽  
Care Treatment ◽  
Care Package ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Treatment Package

BackgroundExisting care models for patients with persistent medically unexplained symptoms (MUS) do not adequately address the needs of these patients. New and innovative intervention strategies are necessary to achieve better health and corresponding economic outcomes.AimTo explore the feasibility of implementing a pragmatic care package that provides primary care treatment for patients with persistent MUS and to evaluate recruitment, retention, and acceptability as well as the potential impact on clinical outcomes and service utilisation.Design & settingProspective cohort intervention study involving a cluster of seven GP surgeries in Newham, East London, providing a 'One-Stop-Shop' primary care treatment service.MethodThe care package included: identification, assessment, engagement, psychoeducation, and a choice of group interventions (mindfulness-based stress reduction [MBSR] and body-oriented psychological therapy [BOPT]). Baseline and follow-up data on somatic symptom levels (PHQ-15), health-related quality of life (SF-36, EQ-5D) and service utilisation was analysed.ResultsIn total, 145 patients were referred and assessed for eligibility, and 93 were included in the study. Participants engaged well with different components of the care package and gained significant improvements in somatic symptom levels with corresponding increases of quality-of-life ratings and a reduction in healthcare utilisation (GP contacts and referrals to specialist services) as well as associated healthcare costs.ConclusionThe primary care treatment package can be successfully implemented in primary care at a relatively low cost and easily adopted into routine care. The body-oriented approach is well accepted by clinicians and patients. Controlled trials should be conducted to test the efficacy of the treatment package.

scholarly journals The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms

2017 ◽  
Vol 56 (2) ◽  
pp. 91-98
Author(s):  
Vojislav Ivetić ◽  
Klemen Pašić ◽  
Polona Selič
Keyword(s):  
Quality Of Life ◽  
Treatment Satisfaction ◽  
Medically Unexplained Symptoms ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Before And After ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Physician Patient

Abstract Introduction Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. Methods In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. Results The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05). Conclusions It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients’ self-rated health status.

scholarly journals Personalized, Web-Based, Guided Self-Help for Patients With Medically Unexplained Symptoms in Primary Care: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Anne van Gils ◽  
Denise Hanssen ◽  
Antoinette van Asselt ◽  
Huibert Burger ◽  
Judith Rosmalen
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Medically Unexplained Symptoms ◽  
Web Based ◽  
Self Help ◽  
Related Quality ◽  
Health Related ◽  
Medically Unexplained ◽  
Unexplained Symptoms

BACKGROUND Medically unexplained symptoms (MUS) constitute a major health problem because of their high prevalence, the suffering and disability they cause, and the associated medical costs. Web-based interventions may provide an accessible and convenient tool for managing MUS. We developed a personalized, Web-based, guided self-help intervention for MUS in primary care (Grip self-help) and would compare its effectiveness with that of usual care. OBJECTIVE This paper aims to describe the rationale, objectives, and design of a pragmatic randomized controlled trial (RCT) assessing the effectiveness of Grip self-help. METHODS For a pragmatic multicenter RCT, 165 adult patients with mild to moderate MUS will be recruited through general practices in the Netherlands. Randomization will be performed at general practice level. Over the course of several months, patients in the intervention group will receive a personalized set of Web-based self-help exercises, targeting the unhelpful cognitions, emotions, behaviors, and social factors that are relevant to them. The intervention is guided by a general practice mental health worker. The control group will receive care-as-usual. Primary outcome is physical health-related quality of life (RAND-36 or 36-item general health survey, physical component score). Secondary outcomes include severity of physical and psychological symptoms, mental health–related quality of life, cost-effectiveness, and acceptability. Assessments will take place at baseline, end of treatment, and at 16-, 26-, and 52-week follow-ups. RESULTS Recruitment started in December 2018, and enrolment is ongoing. The first results are expected to be submitted for publication in December 2021. CONCLUSIONS To our knowledge, this is the first study to combine the concepts of electronic health, self-help, and personalized medicine in the treatment of MUS. By improving the quality of life and reducing symptoms of patients with MUS, Grip self-help has the potential to reduce costs and conserve scarce health care resources. CLINICALTRIAL Dutch Trial Register NTR7390; https://www.trialregister.nl/trial/7390. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/13738

scholarly journals Personalized, Web-Based, Guided Self-Help for Patients With Medically Unexplained Symptoms in Primary Care: Protocol for a Randomized Controlled Trial

10.2196/13738 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e13738 ◽  
Author(s):  
Anne van Gils ◽  
Denise Hanssen ◽  
Antoinette van Asselt ◽  
Huibert Burger ◽  
Judith Rosmalen
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Medically Unexplained Symptoms ◽  
Web Based ◽  
Self Help ◽  
Related Quality ◽  
Health Related ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background Medically unexplained symptoms (MUS) constitute a major health problem because of their high prevalence, the suffering and disability they cause, and the associated medical costs. Web-based interventions may provide an accessible and convenient tool for managing MUS. We developed a personalized, Web-based, guided self-help intervention for MUS in primary care (Grip self-help) and would compare its effectiveness with that of usual care. Objective This paper aims to describe the rationale, objectives, and design of a pragmatic randomized controlled trial (RCT) assessing the effectiveness of Grip self-help. Methods For a pragmatic multicenter RCT, 165 adult patients with mild to moderate MUS will be recruited through general practices in the Netherlands. Randomization will be performed at general practice level. Over the course of several months, patients in the intervention group will receive a personalized set of Web-based self-help exercises, targeting the unhelpful cognitions, emotions, behaviors, and social factors that are relevant to them. The intervention is guided by a general practice mental health worker. The control group will receive care-as-usual. Primary outcome is physical health-related quality of life (RAND-36 or 36-item general health survey, physical component score). Secondary outcomes include severity of physical and psychological symptoms, mental health–related quality of life, cost-effectiveness, and acceptability. Assessments will take place at baseline, end of treatment, and at 16-, 26-, and 52-week follow-ups. Results Recruitment started in December 2018, and enrolment is ongoing. The first results are expected to be submitted for publication in December 2021. Conclusions To our knowledge, this is the first study to combine the concepts of electronic health, self-help, and personalized medicine in the treatment of MUS. By improving the quality of life and reducing symptoms of patients with MUS, Grip self-help has the potential to reduce costs and conserve scarce health care resources. Trial Registration Dutch Trial Register NTR7390; https://www.trialregister.nl/trial/7390. International Registered Report Identifier (IRRID) PRR1-10.2196/13738

Health-Related Quality of Life in Older Persons with Medically Unexplained Symptoms

2016 ◽  
Vol 24 (11) ◽  
pp. 1117-1127 ◽  
Author(s):  
Denise J.C. Hanssen ◽  
Peter L.B.J. Lucassen ◽  
Peter H. Hilderink ◽  
Paul Naarding ◽  
Richard C. Oude Voshaar
Keyword(s):  
Quality Of Life ◽  
Older Persons ◽  
Medically Unexplained Symptoms ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Medically Unexplained ◽  
Unexplained Symptoms
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