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GP clinic ‘helps patients deal with unexplained symptoms’

A specialist clinic for patients with medically unexplained symptoms (MUS) in primary care can have a ‘clinically meaningful’ improvement on their quality of life, say UK researchers.

The pilot study looked at 32 patients from six north-east Edinburgh GP surgeries who had multiple specialist referrals and current disease symptoms that their GP believed could not be adequately explained by physical disease.

Patients were allocated randomly to two arms – usual care or a series of four clinic appointments with a GP with a special interest in MUS – and their quality of life was assessed at baseline and after the intervention.

Both study arms showed an improvement in quality of life, but improvements were more marked in the intervention group. The differences in Patient Health Questionnaire (PHQ-14) scores in the intervention group were 3.3, compared with 2.2 in the usual care group, and this difference was statistically significant when one outlier was removed.

Eight out of the 11 patients randomised to the clinic appointment reported it had helped them deal with their problems, and study leader Dr Christopher Burton, GP and senior research fellow at the University of Edinburgh, said MUS sufferers often incurred substantial health costs with repeated consultations, but the clinic results ‘are in keeping with clinically meaningful benefit’.