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CBT to reduce healthcare use for medically unexplained symptoms: systematic review and meta analysis

Jones, B; Williams, ACDC; (2019) CBT to reduce healthcare use for medically unexplained symptoms: systematic review and meta analysis. British Journal of General Practice , 69 (681) E262-E269. 10.3399/bjgp19X701273.

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Abstract

Background: Studies have reported that medically unexplained symptoms (MUS) tend to be associated with increased healthcare use, which is demanding of resources and potentially harmful to patients. This association is often used to justify the funding and study of psychological interventions for MUS, yet no systematic review has specifically examined the efficacy of psychological interventions in reducing healthcare use. / Aim: To conduct a systematic review and meta-analysis to evaluate the effectiveness of cognitive behavioural therapies (CBT) for MUS in reducing healthcare use. / Design and setting: Systematic review and meta-analysis. / Method: The search from a previous systematic review was updated and expanded. Twenty-two randomised controlled trials reported healthcare use, of which 18 provided data for meta-analysis. Outcomes were healthcare contacts, healthcare costs, medication, and medical investigations. / Results: Small reductions in healthcare contacts and medication use were found for CBT compared with active controls, treatment as usual, and waiting list controls, but not for medical investigations or healthcare costs. / Conclusion: Cognitive behavioural interventions show weak benefits in reducing healthcare use in people with MUS. The imprecise use of MUS as a diagnostic label may impact on the effectiveness of interventions, and it is likely that the diversity and complexity of these difficulties may necessitate a more targeted approach.

Type: Article
Title: CBT to reduce healthcare use for medically unexplained symptoms: systematic review and meta analysis
DOI: 10.3399/bjgp19X701273
Publisher version: https://doi.org/10.3399/bjgp19X701273
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: behaviour therapy, chronic pain, cognitive therapy, meta-analysis, somatoform disorders, systematic review
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10075120
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