TY - JOUR
KW - Adult
KW - Cluster Analysis
KW - Denmark
KW - Education, Medical, Continuing/methods
KW - Family Practice/methods
KW - Female
KW - Follow-Up Studies
KW - Health Status
KW - Humans
KW - Male
KW - Middle Aged
KW - Outcome and Process Assessment (Health Care)/methods/statistics & numerical data
KW - Physicians, Family/education
KW - Primary Health Care/methods
KW - Questionnaires
KW - Somatoform Disorders/psychology/therapy
AU - T. Toft
AU - M. Rosendal
AU - E. Ornbol
AU - F. Olesen
AU - L. Frostholm
AU - P. Fink
A1 - 
AB - BACKGROUND: Patients with medically unexplained or functional somatic symptoms (FSS) are prevalent in primary care. In this pragmatic cluster-randomised controlled trial we aimed to test the effect of a training programme (The Extended Reattribution and Management model) for general practitioners (GPs) in the treatment of FSS. METHODS: 38 participating GPs were randomised to the control group or the training group. The GPs included consecutive 18- to 65-year-old patients presenting during a 3-week period for new health complaints. We assessed a stratified subsample with the psychiatric interview Schedules of Clinical Assessment in Neuropsychiatry. Of 701 patients interviewed, 350 fulfilled the diagnostic criteria for any ICD-10 somatoform disorder (SD) and 111 presented FSS without fulfilling these criteria (sub-threshold SD). Patients completed questionnaires at baseline and after 3, 12 and 24 months. The questionnaires included assessment of health status (36-item Medical Outcomes Study Short Form; SF-36), health anxiety (Whiteley-7) and physical symptoms (Symptom Check List-90, somatization subscale). RESULTS: Patients with SD consulting trained GPs improved more on our primary outcome of physical functioning than patients consulting control GPs at the 3-month follow-up (p = 0.004), but the improvement was not statistically significant at later follow-up. We found no significant differences in improvement between patients with SD and those with sub-threshold SD. Results for other SF-36 subscales, physical symptoms and health anxiety only showed statistically significant differences between the intervention and control groups for patients with SD; patients consulting trained GPs had less improvement in vitality, health anxiety and physical symptoms at 24 months compared with the control group. CONCLUSIONS: GP training may accelerate improvement in physical functioning for patients with SD. However, the effect is small and may not be clinically significant.
BT - Psychotherapy and psychosomatics
C5 - Education & Workforce; Medically Unexplained Symptoms
CP - 4
CY - Switzerland
DO - 10.1159/000313691
IS - 4
JF - Psychotherapy and psychosomatics
N2 - BACKGROUND: Patients with medically unexplained or functional somatic symptoms (FSS) are prevalent in primary care. In this pragmatic cluster-randomised controlled trial we aimed to test the effect of a training programme (The Extended Reattribution and Management model) for general practitioners (GPs) in the treatment of FSS. METHODS: 38 participating GPs were randomised to the control group or the training group. The GPs included consecutive 18- to 65-year-old patients presenting during a 3-week period for new health complaints. We assessed a stratified subsample with the psychiatric interview Schedules of Clinical Assessment in Neuropsychiatry. Of 701 patients interviewed, 350 fulfilled the diagnostic criteria for any ICD-10 somatoform disorder (SD) and 111 presented FSS without fulfilling these criteria (sub-threshold SD). Patients completed questionnaires at baseline and after 3, 12 and 24 months. The questionnaires included assessment of health status (36-item Medical Outcomes Study Short Form; SF-36), health anxiety (Whiteley-7) and physical symptoms (Symptom Check List-90, somatization subscale). RESULTS: Patients with SD consulting trained GPs improved more on our primary outcome of physical functioning than patients consulting control GPs at the 3-month follow-up (p = 0.004), but the improvement was not statistically significant at later follow-up. We found no significant differences in improvement between patients with SD and those with sub-threshold SD. Results for other SF-36 subscales, physical symptoms and health anxiety only showed statistically significant differences between the intervention and control groups for patients with SD; patients consulting trained GPs had less improvement in vitality, health anxiety and physical symptoms at 24 months compared with the control group. CONCLUSIONS: GP training may accelerate improvement in physical functioning for patients with SD. However, the effect is small and may not be clinically significant.
PB - S. Karger AG, Basel
PP - Switzerland
PY - 2010
SN - 1423-0348; 0033-3190
SP - 227
EP - 237
EP - 
T1 - Training general practitioners in the treatment of functional somatic symptoms: Effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study)
T2 - Psychotherapy and psychosomatics
TI - Training general practitioners in the treatment of functional somatic symptoms: Effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study)
U1 - Education & Workforce; Medically Unexplained Symptoms
U2 - 20424500
U3 - 10.1159/000313691
VL - 79
VO - 1423-0348; 0033-3190
Y1 - 2010
ER -