Predictors of treatment outcomes for patients with persistent physical symptoms in primary care: findings from a cluster randomised controlled trial.

Abstract

Persistent physical symptoms (PPS) are consistently prevalent among primary care patients. PPS can negatively affect quality of life, healthcare costs, and work participation. In a previous study, we found substantially improved outcomes and reduced sick leave for patients treated by a work-focused communication tool, known as the Individual Challenge Inventory Tool (ICIT), compared with a control group. To examine predictors of treatment outcome in patients who received treatment by ICIT, delivered by the patient's GP. This study is based on the findings of our previous cluster randomised controlled trial undertaken in Norway. Regression analyses of the intervention group were used to identify predictors (all measured at baseline) of improvements in Patient Global Impression of Change (PGIC) and sick leave after 11 weeks follow-up. Living alone predicted improvement in the adjusted model (odds ratio [OR] 4.03, 95% confidence interval [CI] = 1.33 to 12.25, <i>P</i> = 0.014). Receiving long-term benefits predicted improved PGIC in both the unadjusted (OR 2.30, 95% CI = 1.21 to 4.39, <i>P</i> = 0.011) and adjusted models (OR 2.46, 95% CI = 1.04 to 5.83, <i>P</i> = 0.040). In addition, living alone predicted reduced sick leave in the adjusted model (OR 3.23, 95%CI = 1.11 to 9.42, <i>P</i> = 0.032). In general, there were few factors to predict the outcome of the work-focused communication tool. We therefore suggest that this work-focused communication tool is applicable to most patients with PPS. GPs may consider using the ICIT for all primary care patients who exhibit ineffective coping strategies in their daily lives and work, especially those who live alone.