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Enhanced care by generalists for functional somatic symptoms and disorders in primary care

Esta versión no es la más reciente

ver la versión actual 18 octubre 2013

Appendices

Appendix 1. CCDAN Registers search strategy

CCDANCTR‐Studies
Treatment setting = “general practice” or “family practice” or “primary care”
and
Diagnosis= “medically unexplained” or “frequent attend*” or “high util*” or somat* or neurasthen* or hyprochondria* or hysteri* or pain or "chronic fatigue"

CCDANCTR‐References
Free‐text = “general practi*” or “family practi*” or “primary care” or "primary health*" or "physicians, family"
or Title/Abstract = GP*
and
Free‐text = “medically unexplained” or “frequent attend*” or “high util*” or somat* or neurasthen* or hyprochondria* or hysteri* or "chronic fatigue"

Appendix 2. MEDLINE search strategy

  1. SOMATOFORM DISORDER/ or NEURASTHENIA/ or HYPOCHONDRIASIS/

  2. NEUROCIRCULATORY ASTHENIA/

  3. (somatoform or somati#ation or somati#ing or somati#ed or somatic symptom$ or somatic syndrome$ or symptom syndrome$ or multisomat$ or neurastheni$ or hypochondria$).ti,ab.

  4. ((medic$ adj3 (unexplain$ or inexplic$)) or unexplained symptom$).ti,ab.

  5. (((frequent or high) adj1 attend$) or high utili#er$ or repeat$ present$).ti,ab.

  6. functional symptoms.ti,ab.

  7. reattribution.ti,ab.

  8. exp ABDOMINAL PAIN/

  9. stomach ache$.ti,ab

  10. exp BACK PAIN/

  11. COLONIC DISEASES, FUNCTIONAL/

  12. CYSTITIS, INTERSTITIAL/

  13. painful bladder syndrome.ti,ab.

  14. urethral syndrome.ti,ab.

  15. cardiac neuros$.ti,ab.

  16. ((non cardiac or noncardiac or non‐cardiac) adj chest pain).ti,ab.

  17. ((nonorganic or non organic or non‐organic) adj pain).ti,ab.

  18. effort syndrome.ti,ab.

  19. DIZZINESS/

  20. FIBROMYALGIA/

  21. FATIGUE SYNDROME, CHRONIC/

  22. myalgic encephalomyel$.ti,ab.

  23. (post viral or postviral or post‐viral) adj (fatigue or syndrome).ti,ab.

  24. exp HEADACHE

  25. exp HEADACHE DISORDERS

  26. exp HYPERVENTILATION

  27. exp HYSTERIA

  28. Briquet's syndrome.ti,ab.

  29. IRRITABLE BOWEL SYNDROME/

  30. MULTIPLE CHEMICAL SENSITIVITY/

  31. exp PELVIC PAIN

  32. exp PREMENSTRUAL SYNDROME

  33. PSYCHOPHYSIOLOGIC DISORDERS

  34. (psychalgia or psychogenic or psychoseizure$ or psychosomatic).ti,ab.

  35. TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME

  36. urethral syndrome.ti,ab.

  37. or/1‐36

  38. exp PRIMARY HEALTHCARE/

  39. PHYSICIANS, FAMILY/

  40. FAMILY PRACTICE/

  41. FAMILY HEALTCARE/

  42. NURSE PRACTIONERS/

  43. ((family or community) adj (medic$ or doctor$ or physician$ or nurs$ or health))).ti,ab.

  44. ((general or family or nurs$) adj1 (practice$ or practitioner$)).ti,ab.

  45. (primary care or primary healthcare or primary health care or primary health service$ or homecare or care in the community).ti,ab.

  46. GP$ or generalist$.ti,ab.

  47. or/38‐46

  48. randomized controlled trial.pt.

  49. controlled clinical trial.pt.

  50. randomi#ed.ab.

  51. placebo$.ab.

  52. exp Clinical Trials as Topic/

  53. randomly.ab.

  54. trial.ti.

  55. or/48‐54

  56. (animals not (humans and animals)).sh.

  57. 55 not 56

  58. 37 and 47 and 57

Table 1. Instruments for the assessment and sampling of functional somatic symptoms and disorders (preliminary overview)

Type of instrument

Name

references

Questionnaire

Abridged criteria

Escobar 1989

 

PHQ‐15

Kroenke 2002

 

SCL‐som

Derogatis 1977

 

Whiteley‐7

Fink 1999

Interview

SCAN

World Health Organisation 1998 

 

DIS

Eaton 2000; Robins 1989

 

CIDI

Andrews 1995; World Health Organisation 1990

Health care use

Frequent attendance

Blankenstein 2001; Katon 1992;Portegijs 1996; Schilte 2001

The table may be supplemented by specific instruments for functional somatic syndromes

The final review will also include a table of names and classification terms
Figuras y tablas -
Table 1. Instruments for the assessment and sampling of functional somatic symptoms and disorders (preliminary overview)
Ir a la tabla del protocolo
Table 2. Data extraction form

Rubric

Reviewer 1

Reviewer 2

Conclusion

Author name

 

 

 

Title of paper

 

 

 

Name of study

 

 

 

Personal notes (e.g. name of disorder used)

 

 

 

Reason for exclusion

 

 

 

Study characteristics

 

 

 

 

Assessment of methods (table 2)

 

 

 

 

Setting of the study (the primary care organisation)

 

 

 

 

Level of randomisation and measures of clustering

 

 

 

 

The risk of contamination (control patients receiving intervention unintentional or vice versa)

 

 

 

 

Doctor characteristics and sampling (previous training, years in practice, GP age)

 

 

 

 

Patient characteristics (inclusion, exclusion, ethnicity, diagnosis, symptom duration, psychiatric co‐morbidity) and sampling (population screening, waiting room screening, GP assessment, diagnostic instruments used)

 

 

 

 

Intervention* in active group

 

 

 

 

Intervention in control group

 

 

 

 

Outcome measure and instrument for assessment (primary outcome, secondary outcome, subgroups)

 

 

 

 

Length of maximum follow‐up

 

 

 

 

Results

 

 

 

* Interventions

  • Training (duration, content, skills training, supervision)

  • Treatment model: reattribution and how close it is to the original, psychosocial interventions other than reattribution). To which degree does the model for patients stipulate that physical symptoms are secondary to psychosocial distress.

  • Clinicians (GP, nurse, other)

  • Organisation (flagging of patients, consultation duration, number of consultations, no changes)

Figuras y tablas -
Table 2. Data extraction form
Ir a la tabla del protocolo