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Open Trial of Integrated Primary Care Consultation for Medically Unexplained Symptoms

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Abstract

Within primary care settings, patients with medically unexplained symptoms (MUS) are common, often present with comorbid psychopathology, and have high rates of healthcare utilization. Despite increased healthcare utilization, these patients often have poor outcomes that frustrate patients and providers alike. A behavioral consultation intervention for primary care patients with MUS (n = 10) was developed and assessed. All participants completed all intervention and assessment sessions and rated the intervention favorably. Participants self-report scores revealed statistically significant improvements from baseline to 3-month follow-up on physical functioning, mental functioning, and physical symptoms. Notwithstanding the limitations of open trial designs, these findings demonstrate high feasibility for a behavioral health consultation treatment model for patients with MUS and highlight the need for further research.

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Notes

  1. Recommendations to PCPs for managing MUS were adapted from previous studies (Smith, 1986, Dickinson, 2002) that demonstrated efficacy for an intervention consisting of sending PCPs a generic letter outlining recommendations for managing MUS patients (e.g., regular visits every 2–8 weeks, limited referrals to specialists, conducting physical exams at every visit, etc.)

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Authors and Affiliations

  1. Department of Family Medicine, Helen and Arthur E. Johnson Depression Center, University of Colorado School of Medicine, 13199 E. Montview Blvd., Suite 330, Aurora, CO, 80045, USA

    Sam Hubley PhD

  2. Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA

    Lisa A. Uebelacker PhD, Justin Nash PhD & Charles B. Eaton MD, MS

  3. Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Brown University, Providence, RI, USA

    Lisa A. Uebelacker PhD & Charles B. Eaton MD, MS

  4. Department of Epidemiology, Brown University, Providence, RI, USA

    Lisa A. Uebelacker PhD & Charles B. Eaton MD, MS

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  1. Sam Hubley PhD
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  2. Lisa A. Uebelacker PhD
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  3. Justin Nash PhD
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  4. Charles B. Eaton MD, MS
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Correspondence to Sam Hubley PhD.

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Hubley, S., Uebelacker, L.A., Nash, J. et al. Open Trial of Integrated Primary Care Consultation for Medically Unexplained Symptoms. J Behav Health Serv Res 44, 590–601 (2017). https://doi.org/10.1007/s11414-016-9528-5

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  • DOI: https://doi.org/10.1007/s11414-016-9528-5

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