ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 16
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Increased quality of life, reduced symptoms and sick leave
in patients with medically unexplained physical symptoms:
A cRCT in primary care
Mrs Cathrine Abrahamsen
Department of General Practice, Institute of Health and Society, University of Oslo
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Objective
To compare the effectiveness of a structured work-related cognitive behavioural therapy
communication tool (Individual Challenge Inventory Tool [ICIT]) in patients with medically unexplained
physical symptoms (MUPS) with usual care.
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Design
Population-based randomised controlled trial
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Setting
Primary care at general practitioner (GP) family practices.
Participants
103 GPs. Patients with MUPS who visited their regular GP. In total, 541 participants aged 18 years or
older.
Intervention
We conducted a two-arm randomised cluster study in Norway. Groups of GPs (clusters) were
randomly assigned to use the ICIT communication tool or usual care for 11 weeks. The intervention
consisted of two or more sessions with their GP.
Main outcome measures
The primary outcome is patient-rated measure in disability, symptoms and quality of life assessed by
the Patient Global Impression of Change (PGIC), work-related self-efficacy (RTW-SE), health-related
quality of life (RAND-36), sick leave and whether the participants accepted the intervention (PEQ).
Results
Compared with usual care (n = 236), the intervention group (n = 223) showed an overall improvement
in disability, symptoms and quality of life measured by PGIC (mean difference 0.79; 95% CI: 2.71, 2.96;
P = 0.000). The sick leave rate was reduced by an average of 2.5 percentage points in the usual care
group compared with 26.4 percentage points in the intervention group. The difference in sick leave
rate was 23.9 percentage points (95% CI: 17.4, 30.5); P = 0.00.
Conclusion
To our knowledge, this is the first study carried out in primary care showing positive outcomes in
patients with MUPS. The use of the communication tool ICIT improved symptoms, health-related
quality of life, increased work-related self-efficacy and reduced sick leave in patients with MUPS. Sick
leave is a major concern to all governments throughout the world. If a communication tool such as ICIT
impacts sick leave rates, it may be a valuable addition to reduce sickness benefits costs.
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