An interprofessional approach to treat bodily distress disorder in Swiss primary care - a quality improvement study

Managing bodily distress disorder (BDD) requires an interprofessional, holistic therapeutic approach, which can be challenging to implement in routine care.

The aim was to evaluate a care pathway for patients with BDD involving general practitioners (GPs) and physiotherapists.

Participants were patients aged 18 years or older with BDD symptoms and the PHQ-15 (Patient Health Questionnaire 15-Item) score > 9. The treatment consisted of patient education by GPs about BDD and stress, sleep interventions, physical exercises and support to develop an active lifestyle (> 150 min per week of moderate-intensity physical activity), as measured with the Physical Activity Vital Sign (PAVS). Patient outcomes (PHQ-15 and PAVS) were compared at baseline and after six months. A survey assessed the perspectives of both patients and health professionals about the treatment.

A total of 70 patients treated by 11 GPs and 6 physiotherapists were involved. Comparing outcomes at baseline vs. after six months (median [IQR]): PHQ-15 decreased, 14 [11, 17] vs. 8 [5, 12], p < 0.001; PAVS increased, 60 [30, 120] vs. 120 [60, 180], p < 0.001; GP confidence (scale 0-100) in treating BDD increased, 50 [38, 66] vs. 82 [66, 85], p = 0.005. Feedback from patients, GPs and physiotherapists about the intervention was positive.

The interprofessional care pathway for patients with BDD had a positive impact on patient outcomes, GP treatment confidence, and was well-received by both patients and health professionals. It can be adapted across primary care systems and tailored to local contexts to improve the quality of care.