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Table 3 Overview of management strategies

From: Management of patients with persistent medically unexplained symptoms: a descriptive study

Management strategies

n of consultations a (%) b

n of patients

Diagnostic strategies

Exploration of symptoms

36 (3.5)

22

Physical examination

254 (24.5)

67

Additional investigations within GP practice

151 (14.6)

61

 Laboratory tests

115 (11.1)

57

 ECG

17 (1.6)

14

 X-ray

22 (2.1)

16

 Echography

7 (0.7)

7

 Other

7 (0.7)

7

Diagnostic referral

34 (3.3)

27

Discussing test results

62 (6.0)

39

Therapeutic strategies

Shared problem definition

4 (0.4)

4

Education and explanation

116 (11.2)

46

Advice

112 (10.8)

45

 Lifestyle/dietary advice

53 (5.1)

31

 Physical exercise advice

52 (5.0)

28

 Other advice

17 (1.7)

13

Symptom diary

12 (1.2)

10

Shared plan for symptom management

48 (4.6)

28

Setting up a time contingent plan

1 (0.1)

1

Discussing/giving advice about medication

97 (9.4)

35

Medication

255 (24.6)

65

 Over the counter medication (OTC)

69 (6.7)

30

 Prescribed medication

201 (19.4)

62

  NSAIDs

37 (3.6)

24

  Opioids

31 (3.0)

19

  Psychopharmacological medication

35 (3.4)

20

  Sleeping medication

25 (2.4)

15

  Antibiotics

7 (0.7)

6

  Other

83 (8.0)

44

 Unclear OTC or prescribed medication

6 (0.6)

5

Vitamin pills/injections

121 (11.7)

12

Medication adjustment

71 (6.9)

29

 Dose increase

22 (2.1)

15

 Dose reduction

18 (1.7)

13

 Discontinuation

37 (3.6)

21

Refill prescription

28 (2.7)

11

Referral within primary care

47 (4.5)

31

 Physiotherapist

25 (2.4)

18

 Mental health nurse practitioner

14 (1.4)

12

 Other

9 (0.9)

9

Physiotherapist appointment

27 (2.6)

20

Mental health nurse practitioner appointment

29 (2.8)

8

Referral to secondary care for treatment

26 (2.5)

18

 Medical specialist

14 (1.4)

9

 Rehabilitation

15 (1.4)

13

Referral to secondary care (unclear for diagnostics or treatment)

46 (4.4)

31

 Rheumatologist

11 (1.1)

10

 Neurologist

10 (1.0)

9

 Gastroenterologist

7 0.7)

6

 Internist

6 (0.6)

6

 Psychiatrist

1 (0.1)

1

 Other

12 (1.1)

12

Referral to a psychologist

5 (0.5)

5

GP consulting another health professional

46 (4.4)

22

 Colleague GP

21 (2.0)

6

 Secondary care medical specialist

12 (1.2)

9

 Other

13 (1.3)

10

Discussing progress

168 (16.2)

52

Follow-up appointment

122 (11.8)

51

Contact if necessary

87 (8.4)

41

Wait and see

97 (9.4)

38

Other

44 (4.3)

26

Unspecified

41 (4.0)

1

  1. aDoes not add up to 1035 because GPs recorded more than one ICPC codes during one consultation
  2. bDoes not add up to 100% because GPs recorded more than one ICPC codes during one consultation