TY - JOUR
KW - Adaptation, Psychological
KW - Analysis of Variance
KW - Case Management
KW - Confidence Intervals
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Nurse Practitioners
KW - Physicians, Family
KW - Primary Health Care
KW - Questionnaires
KW - Somatoform Disorders/diagnosis/drug therapy/therapy
KW - Stress, Psychological
AU - R. C. Smith
AU - J. C. Gardiner
AU - Z. Luo
AU - S. Schooley
AU - L. Lamerato
AU - K. Rost
A1 - 
AB - BACKGROUND: We hypothesized that somatizing patients managed by primary care physicians (PCP) would improve with a relationship-based intervention. METHODS: We randomized 30 adults with medically unexplained symptoms to treatment or usual care. Four PCPs were trained to intervene with cognitive-behavioral, pharmacological, and patient-centered management and deployed the intervention with seven scheduled visits over 12 months. Outcomes obtained at baseline and 12 months were: Mental component summary (MCS), the primary endpoint, and measures of physical and psychological symptoms and of satisfaction with the PCP. RESULTS: Patients averaged 52.5 years; 83.3% were female; 79.6% were black. Using a difference of differences approach, we found that the intervention produced a large effect size (ES) (0.82; CI: 0.08 to 1.57) for the MCS in the predicted direction, similar to the ES for physical (-0.80; CI: -1.55 to -0.04) and psychological (-1.06; CI: -1.83 to -0.28) improvement and for increased satisfaction with the PCP (0.94; CI: 0.15 to 1.74). Using ANCOVA in a sensitivity analysis, we found that the ES fell slightly (0.59), while other measures were unchanged. CONCLUSIONS: Moderate-large effect sizes support the hypothesis that PCPs can effectively treat somatization. This points to the importance of performing a full RCT.
BT - Journal of general internal medicine
C5 - Medically Unexplained Symptoms
CP - 7
CY - United States
DO - 10.1007/s11606-009-0992-y
IS - 7
JF - Journal of general internal medicine
N2 - BACKGROUND: We hypothesized that somatizing patients managed by primary care physicians (PCP) would improve with a relationship-based intervention. METHODS: We randomized 30 adults with medically unexplained symptoms to treatment or usual care. Four PCPs were trained to intervene with cognitive-behavioral, pharmacological, and patient-centered management and deployed the intervention with seven scheduled visits over 12 months. Outcomes obtained at baseline and 12 months were: Mental component summary (MCS), the primary endpoint, and measures of physical and psychological symptoms and of satisfaction with the PCP. RESULTS: Patients averaged 52.5 years; 83.3% were female; 79.6% were black. Using a difference of differences approach, we found that the intervention produced a large effect size (ES) (0.82; CI: 0.08 to 1.57) for the MCS in the predicted direction, similar to the ES for physical (-0.80; CI: -1.55 to -0.04) and psychological (-1.06; CI: -1.83 to -0.28) improvement and for increased satisfaction with the PCP (0.94; CI: 0.15 to 1.74). Using ANCOVA in a sensitivity analysis, we found that the ES fell slightly (0.59), while other measures were unchanged. CONCLUSIONS: Moderate-large effect sizes support the hypothesis that PCPs can effectively treat somatization. This points to the importance of performing a full RCT.
PP - United States
PY - 2009
SN - 1525-1497; 0884-8734
SP - 829
EP - 832
EP - 
T1 - Primary care physicians treat somatization
T2 - Journal of general internal medicine
TI - Primary care physicians treat somatization
U1 - Medically Unexplained Symptoms
U2 - 19408058
U3 - 10.1007/s11606-009-0992-y
VL - 24
VO - 1525-1497; 0884-8734
Y1 - 2009
ER -