Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-27T08:36:10.939Z Has data issue: false hasContentIssue false

A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms

Published online by Cambridge University Press:  13 December 2006

JOSÉ M. AIARZAGUENA
Affiliation:
San Inazio Health Care Centre, Basque Health Service (Osakidetza), Bilbao, Spain
GONZALO GRANDES
Affiliation:
Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Spain
IDOIA GAMINDE
Affiliation:
Research and Continuous Education Unit, Department of Health, Government of Navarre, Pamplona, Spain
AGUSTÍN SALAZAR
Affiliation:
San Inazio Health Care Centre, Basque Health Service (Osakidetza), Bilbao, Spain
ÁLVARO SÁNCHEZ
Affiliation:
Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Spain
JULEN ARIÑO
Affiliation:
Psycho-social Module of Deusto-San Ignacio, Bilbao, Spain

Abstract

Background. Somatizing patients are a challenge to general practitioners (GPs). A cluster randomized controlled trial was conducted to asses the effect of specific communication techniques delivered by GPs on somatizing patients' self-perceived health.

Method. Thirty-nine GPs were assigned randomly to two parallel groups. GPs in the intervention group treated somatic patients according to specific communication techniques focused on offering a physical explanation – release of hormones – and approaching sensitive topics in the patient's experience indirectly. Control GPs used the standard Goldberg reattribution technique. A total of 156 patients, aged 18–65 years, were selected randomly from a list of 468 patients with six or more active symptoms for women and four or more for men. All patients had six programmed 30-min consultations. Health-related quality of life (assessed with the 36-item Short-Form Health Survey, SF-36) and a summary utility index were used as outcome measures. Patients were interviewed at home at baseline and at 3, 8 and 12 months after the beginning of the intervention.

Results. Patients in both groups improved in all dimensions of the SF-36. The time course of the quality of life was significantly better for the intervention group in five of the eight scales of the SF-36 (bodily pain, mental health, physical functioning, vitality, and social functioning) and in the utility index (p<0·039).

Conclusions. Communication techniques were found to have a clinically relevant impact on body pain. This finding, together with a trend towards better scores in the remaining scales, justifies the use of these techniques in psychosocial interventions delivered to patients with medically unexplained symptoms.

Type
Original Article
Copyright
2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)