scholarly journals Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0205278 ◽  
Author(s):  
Margreet S. H. Wortman ◽  
Joran Lokkerbol ◽  
Johannes C. van der Wouden ◽  
Bart Visser ◽  
Henriëtte E. van der Horst ◽  
...  
2019 ◽  
Vol 69 (681) ◽  
pp. e262-e269 ◽  
Author(s):  
Brittni Jones ◽  
Amanda C de C Williams

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.


2017 ◽  
Vol 88 (8) ◽  
pp. A32.1-A32
Author(s):  
Anne van Gils ◽  
Robert A Schoevers ◽  
Irma J Bonvanie ◽  
Jeannette M Gelauff ◽  
Annelieke M Roest ◽  
...  

2009 ◽  
Vol 66 (5) ◽  
pp. 363-377 ◽  
Author(s):  
Tim C. olde Hartman ◽  
Machteld S. Borghuis ◽  
Peter L.B.J. Lucassen ◽  
Floris A. van de Laar ◽  
Anne E. Speckens ◽  
...  

Author(s):  
Orla McDevitt-Petrovic ◽  
Karen Kirby

This chapter presents a systematic review of the literature to assess the effectiveness of brief psychological interventions for medically unexplained symptoms (MUS)/somatic symptom disorder, non-cardiac chest pain, and illness anxiety disorder or health anxiety (HA). Google Scholar, PubMed, and Web of Science were searched as data sources. Reference lists were subsequently examined for other relevant articles. Studies were assessed according to specified inclusion criteria and extracted according to PRISMA guidelines. A total of 23 studies were included in the final synthesis. Significant effects for intervention groups relative to control groups were reported in 19 studies, whilst 4 studies did not determine any significant benefits of interventions compared with controls. All of the brief interventions (CBT, psychosocial, psychophysiological, psychosomatic, relaxation and group therapy), with the exception of metaphor therapy, showed significant effects relative to controls in at least one study. The evidence suggests that brief psychological interventions, more specifically time limited CBT based interventions may be effective in treating HA and MUS with psychological distress. Findings are comparable with other reviews. Future research may facilitate the piloting of an intervention, and there remains a need to provide more robust evidence of cost effectiveness.


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