Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms
The British Journal of PsychiatryPublished 30 November 2007Open access
Richard Morriss, Christopher Dowrick, Peter Salmon, Sarah Peters, Graham Dunn, Anne Rogers
Citations114
SJR quartileQ1
SJR score2.47
SNIP2.17
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TL;DR
Practice-based training in reattribution changed doctor–patient communication without improving outcome of patients with medically unexplained symptoms, and was associated with decreased quality of life.
Abstract
BACKGROUND: Reattribution is frequently taught to general practitioners (GPs) as a structured consultation that provides a psychological explanation for medically unexplained symptoms. AIMS: To determine if practice-based training of GPs in reattribution changes doctor-patient communication, thereby improving outcomes in patients with medically unexplained symptoms of 3 months' duration. METHOD: Cluster randomised controlled trial in 16 practices, 74 GPs and 141 patients with medically unexplained symptoms of 6 hours of reattribution training v. treatment as usual. RESULTS: With training, the proportion of consultations mostly consistent with reattribution increased (31 v. 2%, P=0.002). Training was associated with decreased quality of life (health thermometer difference -0.9, 95% CI -1.6 to -0.1; P=0.027) with no other effects on patient outcome or health contacts. CONCLUSIONS: Practice-based training in reattribution changed doctor-patient communication without improving outcome of patients with medically unexplained symptoms.
Keywords
Medicine
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