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BMC Primary Care
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

Authors: Madelon den Boeft, Danielle Huisman, Johannes C. van der Wouden, Mattijs E. Numans, Henriette E. van der Horst, Peter L. Lucassen, Tim C. olde Hartman

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients. We conducted a focus group study to explore how FPs recognize MUPS and whether they recognize specific subgroups of patients with MUPS. Targeting such subgroups might improve treatment outcomes.

Methods

Six focus groups were conducted with in total 29 Dutch FPs. Two researchers independently analysed the data applying the principles of constant comparative analysis in order to detect characteristics to recognize MUPS and to synthesize subgroups.

Results

FPs take into account various characteristics when recognizing MUPS in their patients. More objective characteristics were multiple MUPS, frequent and long consultations and many referrals. Subjective characteristics were negative feelings towards patients and the feeling that the FP cannot make sense of the patient’s story. Experience of the FP, affinity with MUPS, consultation skills, knowledge of the patient’s context and the doctor-patient relationship seemed to influence how and to what extent these characteristics play a role. Based on the perceptions of the FPs we were able to distinguish five subgroups of patients according to FPs: 1) the anxious MUPS patient, 2) the unhappy MUPS patient, 3) the passive MUPS patient, 4) the distressed MUPS patient, and 5) the puzzled MUPS patient. These subgroups were not mutually exclusive, but were based on how explicit and predominant certain characteristics were perceived by FPs.

Conclusions

FPs believe that they can properly identify MUPS in their patients during consultations and five distinct subgroups of patients could be distinguished. If these subgroups can be confirmed in further research, personalized treatment strategies can be developed and tested for their effectiveness.
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Metadata
Title
Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study
Authors
Madelon den Boeft
Danielle Huisman
Johannes C. van der Wouden
Mattijs E. Numans
Henriette E. van der Horst
Peter L. Lucassen
Tim C. olde Hartman
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0451-x

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