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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