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ID
Source
Brief title
Health condition
Medically Unexplained Physical Symptoms; MUPS; Education; Consultation skills training; Communication; Medical specialists; Illness worries; Cost-effectiveness; Randomised Controlled Trial.
Sponsors and support
Secondary sponsors: Faculty Social Sciences of the Erasmus University Rotterdam; VUMC department of General Practice, EMGO+ Institute for Health and Care Research; NIVEL;
Intervention
Outcome measures
Primary outcome
On patient-level we measure with questionnaires:
1. Illness worries with Whiteley Index;
2. Current symptom severity with VAS;
3. Distress, depression, anxiety and somatisation with 4-DSQ;
4. Daily functioning of patients with SF-36.
The questionnaires will be taken at baseline, after 3 months and after 6 months.
Secondary outcome
On doctor-level we measure the application of consultation skills by observation of video-taped consultations and facts from patientfiles.
An economic evaluation will be performed from societal perspective. Costs of the training programme, health care utilization, personal expenses and production loss will be measured. The research team registers the costs of intervention; we measure the other volumina by patient questionnaires.
Background summary
To improve medical specialistic care for patients with medically unexplained physical symptoms (MUPS) by developing and researching the effectiveness and efficiency of a consultation skills training programme for medical specialists focused on MUPS-patients.
Study objective
Training medical specialists in consultation skills focused on MUPS patients improves the specialistic care for these patients in terms of illness worries, course of symptoms and daily functioning and reduces the medical costs for this patient group.
Study design
1. Months 1-2: Preparation;
2. Months 3-20: Datacollection and intervention;
3. Months 21-24: Data-analysis and report.
Intervention
Consultation skills training programme for medical specialists focused on patients with MUPS.
The programme consists of 4 training sessions with an interval of 4 to 6 weeks, in groups of 12 persons with 2 experienced trainers.
Training 1 consists of exploring complaints of patients on all aspects of SCEBS (Somatic, Cognitive, Emotion, Behaviour, Social environment).
In Training 2, informing the patient is the central subject (seek connection with his language etc). Explaining the conditions that maintain the current condition (vicious circles), registration of complaints and reattribution.
Training 3 treats techniques for tough anxiety (stop reassuring, interrogate catastrophic ideas, etc) and ways of refering and reporting back to the GP.
Training 4 gives space for presenting casuistry, where the doctor has worked with the new techniques.
The control group receives no training.
Anne Weiland
Erasmus MC, Department of Internal Medicine
Rotterdam 3000 CA
The Netherlands
+31 (0)6 18559690
a.weiland@erasmusmc.nl
Anne Weiland
Erasmus MC, Department of Internal Medicine
Rotterdam 3000 CA
The Netherlands
+31 (0)6 18559690
a.weiland@erasmusmc.nl
Inclusion criteria
Adult outpatients with MUPS, diagnosed by the participating specialist.
Exclusion criteria
1. Age < 18 years;
2. Not able to comprehend Dutch;
3. Legally incapable.
Design
Recruitment
Followed up by the following (possibly more current) registration
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Other (possibly less up-to-date) registrations in this register
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In other registers
| Register | ID |
|---|---|
| NTR-new | NL2495 |
| NTR-old | NTR2612 |
| Other | ZonMW, VEMI subsidie : 171101012 |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |