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Experts' opinions on the management of medically unexplained symptoms in primary care. A qualitative analysis of narrative reviews and scientific editorials

Heijmans, Mieke; Hartman, Tim C. olde; Weel-Baumgarten, Evelyn van; Dowrick, Christopher; Lucassen, Peter; van Weel, Chris

Description

Background: The feasibility as well as the suitability of several therapies for medically unexplained symptoms (MUS) in primary care applied by the family physician (FP) appeared to be low. FPs need effective and acceptable strategies to manage these functionally impaired patients. Objective: To review important and effective elements in the treatment of patients with MUS in primary care according to experts in MUS research. Methods: We performed a systematic search of narrative reviews and...[Show more]

dc.contributor.authorHeijmans, Mieke
dc.contributor.authorHartman, Tim C. olde
dc.contributor.authorWeel-Baumgarten, Evelyn van
dc.contributor.authorDowrick, Christopher
dc.contributor.authorLucassen, Peter
dc.contributor.authorvan Weel, Chris
dc.date.accessioned2015-12-13T22:50:19Z
dc.identifier.issn0263-2136
dc.identifier.urihttp://hdl.handle.net/1885/80730
dc.description.abstractBackground: The feasibility as well as the suitability of several therapies for medically unexplained symptoms (MUS) in primary care applied by the family physician (FP) appeared to be low. FPs need effective and acceptable strategies to manage these functionally impaired patients. Objective: To review important and effective elements in the treatment of patients with MUS in primary care according to experts in MUS research. Methods: We performed a systematic search of narrative reviews and scientific editorials in Medline and PsycINFO and triangulated our findings by conducting a focus group with MUS experts. Results. We included 7 scientific editorials and 23 narrative reviews. According to MUS experts, the most important elements in the treatment of MUS are creating a safe therapeutic environment, generic interventions (such as motivational interviewing, giving tangible explanations, reassurance and regularly scheduled appointments) and specific interventions (such as cognitive approaches and pharmacotherapy). Furthermore, MUS experts indicate that a multi-component approach in which these three important elements are combined are most helpful for patients with MUS. In contrast to most specific interventions, opinions of MUS experts regarding generic interventions and creating a safe therapeutic relationship seem to be more based on theory and experience than on quantitative research. Conclusions: MUS experts highlight the importance of generic interventions and doctor-patient communication and relationship. However, studies showing the effectiveness of these elements in the management of MUS in primary care is still scarce. Research as well as medical practice should focus more on these non-specific aspects of the medical consultation.
dc.publisherOxford University Press
dc.sourceFamily Practice
dc.subjectKeywords: antidepressant agent; Hypericum perforatum extract; placebo; alternative medicine; anxiety disorder; article; attention; clinical protocol; cognitive therapy; comorbidity; consultation; depression; doctor patient relation; drug efficacy; drug safety; drug Doctor-patient relationship; Family medicine; Mental health; Patient-centred care; Qualitative research
dc.titleExperts' opinions on the management of medically unexplained symptoms in primary care. A qualitative analysis of narrative reviews and scientific editorials
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume28
dc.date.issued2011
local.identifier.absfor111700 - PUBLIC HEALTH AND HEALTH SERVICES
local.identifier.ariespublicationf5625xPUB8996
local.type.statusPublished Version
local.contributor.affiliationHeijmans, Mieke, Radboud University Nijmegen Medical Centre
local.contributor.affiliationHartman, Tim C. olde, Radboud University Nijmegen Medical Centre
local.contributor.affiliationWeel-Baumgarten, Evelyn van, Radboud University Nijmegen Medical Centre
local.contributor.affiliationDowrick, Christopher, Radboud University Nijmegen Medical Centre
local.contributor.affiliationLucassen, Peter, Radboud University Nijmegen Medical Centre
local.contributor.affiliationVan Weel, Chris, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue4
local.bibliographicCitation.startpage444
local.bibliographicCitation.lastpage455
local.identifier.doi10.1093/fampra/cmr004
dc.date.updated2016-02-24T09:44:40Z
local.identifier.scopusID2-s2.0-79961054414
CollectionsANU Research Publications

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