Barriers and facilitators to implementing interventions for medically unexplained symptoms in primary and secondary care: A systematic review

Background. There are few longitudinal studies of patients with medically unexplained symptoms. The aim of this study was to investigate outcome in frequent attenders in secondary care who present repeatedly with medically unexplained symptoms.Method. Forty-eight patients presenting with medically unexplained symptoms, from a sample of 61, participated in a 3-year follow-up study. Psychiatric morbidity, functional impairment and use of services were evaluated.Results. At follow-up there was a high prevalence of psychiatric morbidity with 69% having at least one psychiatric diagnosis. The sample continued to be high users of a range of health services and substantial functional impairment was reported.Conclusion. In this group of frequent attenders with medically unexplained symptoms outcome as measured by psychiatric morbidity, service use and functional impairment remained poor after 3 years.

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Adapted Cognitive-Behavior Therapy for Medically Unexplained Symptoms in Secondary Care Reduces Hospital Contacts

Psychosomatics ◽

10.1016/j.psym.2010.12.008 ◽

2011 ◽

Vol 52 (2) ◽

pp. 194-196 ◽

Cited By ~ 6

Author(s):

Helen Tyrer ◽

Peter Tyrer ◽

Ian Lovett

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Secondary Care ◽

Medically Unexplained Symptoms ◽

Cognitive Behavior ◽

Medically Unexplained ◽

Unexplained Symptoms

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What's ‘difficult’? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2016.09.005 ◽

2016 ◽

Vol 90 ◽

pp. 1-9 ◽

Cited By ~ 9

Author(s):

Anke Maatz ◽

Megan Wainwright ◽

Andrew J. Russell ◽

Jane Macnaughton ◽

Yan Yiannakou

Keyword(s):

Qualitative Analysis ◽

Secondary Care ◽

Medically Unexplained Symptoms ◽

Multi Stage ◽

Medically Unexplained ◽

Unexplained Symptoms

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CBT to reduce healthcare use for medically unexplained symptoms: systematic review and meta-analysis

British Journal of General Practice ◽

10.3399/bjgp19x701273 ◽

2019 ◽

Vol 69 (681) ◽

pp. e262-e269 ◽

Cited By ~ 5

Author(s):

Brittni Jones ◽

Amanda C de C Williams

Keyword(s):

Systematic Review ◽

Healthcare Costs ◽

Meta Analysis ◽

Medically Unexplained Symptoms ◽

Psychological Interventions ◽

Healthcare Use ◽

Cognitive Behavioural ◽

Medically Unexplained ◽

Unexplained Symptoms ◽

Medical Investigations

BackgroundStudies have reported that medically unexplained symptoms (MUS) tend to be associated with increased healthcare use, which is demanding of resources and potentially harmful to patients. This association is often used to justify the funding and study of psychological interventions for MUS, yet no systematic review has specifically examined the efficacy of psychological interventions in reducing healthcare use.AimTo conduct a systematic review and meta-analysis to evaluate the effectiveness of cognitive behavioural therapies (CBT) for MUS in reducing healthcare use.Design and settingSystematic review and meta-analysis.MethodThe search from a previous systematic review was updated and expanded. Twenty-two randomised controlled trials reported healthcare use, of which 18 provided data for meta-analysis. Outcomes were healthcare contacts, healthcare costs, medication, and medical investigations.ResultsSmall reductions in healthcare contacts and medication use were found for CBT compared with active controls, treatment as usual, and waiting list controls, but not for medical investigations or healthcare costs.ConclusionCognitive behavioural interventions show weak benefits in reducing healthcare use in people with MUS. The imprecise use of MUS as a diagnostic label may impact on the effectiveness of interventions, and it is likely that the diversity and complexity of these difficulties may necessitate a more targeted approach.

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