Olde Hartman, T.C., Rosendal, M., Aamland, A. et al. (4 more authors) (2017) What do guidelines and systematic reviews tell us about the management of medically unexplained symptoms in primary care? BJGP Open, 1 (3). 2016-0868. ISSN 2398-3795
Abstract
Medically unexplained symptoms (MUS) are symptoms for which the origin remains unclear despite adequate history taking, physical examination, and additional investigations.1 An estimated 3–11% of patients visiting general practice repeatedly consult their GP for MUS.2,3 MUS exist along a continuum ranging from self-limiting symptoms, to recurrent and persistent symptoms, through to symptom disorders.4 Although there are various terms for the condition, for example unexplained physical symptoms, functional symptoms, or somatoform symptoms, we have chosen to use MUS in this article because this is the most frequently used term. This review aims to address current problems with the management of undifferentiated MUS; specific syndromes within the MUS spectrum, such as chronic fatigue syndrome and irritable bowel syndrome, are excluded from discussion.
Patients with persistent MUS suffer from their symptoms, are functionally impaired, and are at risk of potentially harmful additional testing and treatment.5 Furthermore, these patients commonly express dissatisfaction with the medical care they receive during their illness.6 They feel stigmatised and not taken seriously.7 GPs often experience patients with persistent MUS as difficult and frustrating to manage.8 In addition, MUS are associated with reduced health-related quality of life, higher healthcare and social costs, and costs associated with lost productivity.9,10
The effects of many treatment strategies have been studied in recent decades. However, not all interventions are acceptable or feasible in routine primary care. In the light of the central role of the GP in managing MUS, we will discuss the importance of consultation skills and the effects of specific treatments in primary care. We will do this by way of a narrative review using available national guidelines and Cochrane Reviews in this field.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © BJGP Open 2017. This article is Open Access: CC-BY-NC 4.0 license (https://creativecommons.org/licenses/by-nc/4.0/) |
Keywords: | Medically unexplained symptoms; Primary care; Doctor-patient relationship; Doctor-patient communication; Guidelines; Review |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Academic Unit of Medical Education (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 04 Feb 2019 12:04 |
Last Modified: | 25 Jun 2023 21:41 |
Published Version: | https://doi.org/10.3399/bjgpopen17X101061 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Refereed: | Yes |
Identification Number: | 10.3399/bjgpopen17X101061 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:141715 |