Symptom management for medically unexplained symptoms in primary care: a qualitative study

Area of Science:

• General Practice
• Qualitative Research
• Patient Care

Background:

• General practitioners (GPs) play a key role in managing patients with medically unexplained symptoms (MUS).
• Current understanding of how GPs manage MUS in daily practice is limited.
• GPs often find the care of patients with MUS challenging.

Purpose of the Study:

• To describe the management strategies employed by GPs when encountering patients with MUS in their daily practice.
• To explore the nuances of symptom management within general practice consultations.

Main Methods:

• Qualitative study analyzing 39 video-recorded general practice consultations.
• Thematic analysis was used to identify and categorize management strategies for MUS.
• Data collected from consultations in the Netherlands in 2015.

Main Results:

• 105 management strategies were identified across 39 consultations.
• Nearly half of strategies focused on symptom management, with others including medication, referrals, tests, follow-ups, and watchful waiting.
• Six key themes of symptom management emerged: cognitions/emotions, professional interaction, body focus, symptom knowledge, activity level, and external conditions. Advice was often non-specific and ambiguous.

Conclusions:

• Symptom management constitutes a significant aspect of general practice care for MUS.
• GPs require support to deliver specific and unambiguous symptom management advice to patients with MUS.
• Improving communication clarity can enhance the effectiveness of symptom management strategies.