Evaluating challenges for improving medically unexplained symptoms in US military veterans via provider communication.
L Alison Phillips, Lisa McAndrew, Benjamin Laman-Maharg and 1 others
PMID 28291576WHAT IT FOUND
Veterans with medically unexplained symptoms who said their doctor discussed the symptoms and treatment were more likely to report following treatment.
Being sympathetic and concerned alone was not linked to adherence. Neither communication style was linked to reported health improvement.
Key findings
01Veterans who reported more illness and treatment discussion by their provider were more likely to report past adherence and intentions to adhere.
02When both communication styles were considered together, both were still related to satisfaction, but neither was related to expectations for improvement or reported health change.
0330% of veterans reported that their provider used none of the illness and treatment discussion behaviours.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The response rate was low: only 20% of the entire clinic population responded, and 36 respondents were excluded because they reported no symptoms or no MUS mention. All data came from veterans’ self-report, including provider behaviour, so memory and perception may not match what happened in the visit. The study used single-item measures for several outcomes and did not use standardized adherence measures. The study did not observe medical encounters or measure provider characteristics, so it cannot separate what providers actually did from how veterans remembered it. The survey measured reports and outcomes together, so it cannot show that communication caused adherence, satisfaction, or health change.
The easy way to misread this
Do not conclude that teaching providers to discuss symptoms and treatment will improve health outcomes. The study found links with adherence and satisfaction, but not with expectations for improvement or reported health improvement, and it did not test a communication intervention.