Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

Autor: Weiland A; Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Faculty of Social Sciences, Institute of Psychology, Erasmus University Rotterdam, The Netherlands. Electronic address: info@anneweiland.nl., Blankenstein AH; Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, The Netherlands., Willems MH; Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Van Saase JL; Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Van Daele PL; Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Van der Molen HT; Faculty of Social Sciences, Institute of Psychology, Erasmus University Rotterdam, The Netherlands., Langbroek GB; Faculty of Medicine, Amsterdam Medical Center, University Hospital Amsterdam, The Netherlands., Bootsma A; Department of Internal Medicine, Medical Center Haaglanden, The Hague, The Netherlands., Vriens EM; Department of Neurology, Diakonessenhuis Utrecht, The Netherlands., Oberndorff-Klein Woolthuis A; Department of Gastroenterology, Diakonessenhuis Utrecht, The Netherlands., Vernhout RM; Clinical Trial Center, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Arends LR; Faculty of Social Sciences, Institute of Psychology, Erasmus University Rotterdam, The Netherlands; Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Faculty of Social Sciences, Institute of Pedagogical Sciences, Erasmus University Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2015 Oct; Vol. 98 (10), pp. 1229-35. Date of Electronic Publication: 2015 Jul 02.
DOI: 10.1016/j.pec.2015.06.021
Abstrakt: Objective: To evaluate effects of a communication training for specialists on the quality of their reply letters to general practitioners (GPs) about patients with medically unexplained physical symptoms (MUPS).
Methods: Before randomization, specialists included ≤3 MUPS patients in a multi-center cluster-randomized trial. In 14h of MUPS-specific communication training, 2.5h focused on reply letters. Letters were discussed with regard to reporting and answering GPs' referral questions and patients' questions, and to reporting findings, explaining MUPS with perpetuating factors and giving advice. After the training, all doctors again included ≤3 MUPS patients. Reply letters to GPs were assessed for quality and blindly rated on a digital scale.
Results: We recruited 478 MUPS patients and 123 specialists; 80% of the doctors wrote ≥1 reply letters, 285 letters were assessed. Trained doctors reported (61% versus 37%, OR=2.55, F(1281)=6.60, p(group*time)=.01) and answered (63% versus 33%, OR=3.31, F(1281)=5.36, p(group*time)=.02) patients' questions more frequently than untrained doctors.
Conclusion: Training improves reply letters with regard to patients' questions, but not with regard to the following: GPs' referral questions, somatic findings, additional testing, explaining, and advice.
Practice Implications: Training specialists to write appropriate reply letters needs more focus on explanation and advice.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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