Explaining persistent physical symptoms to patients in general practice: can tests to measure central sensitisation...

Area of Science:

• Pain Medicine
• General Practice
• Patient Education

Background:

• Persistent physical symptoms (PPS) pose challenges for GPs in explaining symptom persistence.
• Central sensitisation (CS) is a potential mechanism, but GPs lack routine testing methods.
• Assessing CS could improve patient understanding of their symptoms.

Purpose of the Study:

• To explore the value of applying tests for central sensitisation (CS) in enhancing explanations to patients.
• To evaluate the feasibility and utility of CS assessment tools in primary care.

Main Methods:

• Prospective study involving 25 GPs applying three CS assessment tests: Central Sensitisation Inventory (CSI), algometer (PPT), and monofilament (temporal summation).
• Quantitative analysis of patient and GP questionnaires.
• Qualitative analysis of GP focus groups and patient interviews.

Main Results:

• All tested methods were feasible in consultations, with 60% taking 5-10 minutes.
• An additional consultation was needed in 50% of cases.
• The CSI identified CS symptoms more frequently (74%) than the algometer (46%) or monofilament (43%).
• Two-thirds of patients found tests valuable; 50% reported clearer CS explanations when tests were used.

Conclusions:

• CS testing is feasible in primary care, though often requires an extra appointment.
• GPs favored the CSI for its higher yield in detecting CS-related symptoms.
• Patient-reported value and clearer explanations suggest utility for CS assessment tools.