TY - JOUR
KW - Anxiety/complications
KW - Cognitive Therapy/methods
KW - Cooperative Behavior
KW - Depression/complications
KW - Humans
KW - Michigan
KW - patient care
KW - Patient Care Planning
KW - Patient-Centered Care/methods
KW - Practice Guidelines as Topic/standards
KW - Primary Health Care
KW - Professional-Patient Relations
KW - Psychology
KW - Somatoform Disorders/psychology/therapy
AU - R. C. Smith
AU - C. Lein
AU - C. Collins
AU - J. S. Lyles
AU - B. Given
AU - F. C. Dwamena
AU - J. Coffey
AU - A. Hodges
AU - J. C. Gardiner
AU - J. Goddeeris
AU - C. W. Given
A1 - 
AB - BACKGROUND: There are no proven, comprehensive treatments in primary care for patients with medically unexplained symptoms (MUS) even though these patients have high levels of psychosocial distress, medical disability, costs, and utilization. Despite extensive care, these common patients often become worse. OBJECTIVE: We sought to identify an effective, research-based treatment that can be conducted by primary care personnel. DESIGN: We used our own experiences and files, consulted with experts, and conducted an extensive review of the literature to identify two things: 1). effective treatments from randomized controlled trials for MUS patients in primary care and in specialty settings; and 2). any type of treatment study in a related area that might inform primary care treatment, for example, depression, provider-patient relationship. MAIN RESULTS: We developed a multidimensional treatment plan by integrating several areas of the literature: collaborative/stepped care, cognitive-behavioral treatment, and the provider-patient relationship. The treatment is designed for primary care personnel (physicians, physician assistants, nurse practitioners) and deployed intensively at the outset; visit intervals are progressively increased as stability and improvement occur. CONCLUSION: Providing a comprehensive treatment plan for chronic, high-utilizing MUS patients removes one barrier to treating this common problem effectively in primary care by primary care personnel.
BT - Journal of general internal medicine
C5 - Medically Unexplained Symptoms
CP - 6
CY - United States
IS - 6
JF - Journal of general internal medicine
N2 - BACKGROUND: There are no proven, comprehensive treatments in primary care for patients with medically unexplained symptoms (MUS) even though these patients have high levels of psychosocial distress, medical disability, costs, and utilization. Despite extensive care, these common patients often become worse. OBJECTIVE: We sought to identify an effective, research-based treatment that can be conducted by primary care personnel. DESIGN: We used our own experiences and files, consulted with experts, and conducted an extensive review of the literature to identify two things: 1). effective treatments from randomized controlled trials for MUS patients in primary care and in specialty settings; and 2). any type of treatment study in a related area that might inform primary care treatment, for example, depression, provider-patient relationship. MAIN RESULTS: We developed a multidimensional treatment plan by integrating several areas of the literature: collaborative/stepped care, cognitive-behavioral treatment, and the provider-patient relationship. The treatment is designed for primary care personnel (physicians, physician assistants, nurse practitioners) and deployed intensively at the outset; visit intervals are progressively increased as stability and improvement occur. CONCLUSION: Providing a comprehensive treatment plan for chronic, high-utilizing MUS patients removes one barrier to treating this common problem effectively in primary care by primary care personnel.
PP - United States
PY - 2003
SN - 0884-8734; 0884-8734
SP - 478
EP - 489
EP - 
T1 - Treating patients with medically unexplained symptoms in primary care
T2 - Journal of general internal medicine
TI - Treating patients with medically unexplained symptoms in primary care
U1 - Medically Unexplained Symptoms
U2 - 12823656
VL - 18
VO - 0884-8734; 0884-8734
Y1 - 2003
ER -