The purpose of this study is to check the medical efficacy and economic benefits of multidisciplinary care in patients with unexplained medical complaints and consume medical services frequently.
Background: Somatic or "medically unexplained" symptoms and syndromes are common and are seen by physicians across almost every medical specialty. In many instances, these phenomena can cause a great deal of pain and frustration, restrict function and reduce patients' quality of life. Despite their frequency and severity, medical personnel often experience a great deal of difficulty in coping with such complaints and patients may be shuttled from specialist to specialist, often with little or no symptomatic relief and at a great deal of expense to the medical system. Many researchers now believe that these seemingly unrelated and "unexplained" conditions in fact share common psycho-physiological mechanisms, such as being catalyzed as a result of trauma or excessive stress, being mediated by the limbic system and affecting inhibitory sensory pathways. Purpose of the study: Testing the efficacy and cost-efficiency of a holistic multidisciplinary treatment methodology for medically unexplained symptoms (MUS). Stages of the Study: The study wil lbe conducted via two arms: 1. A reterospective study of patients attending the Functional Neurology clinic a Soroka UMC between the years 2014-2018 in which patient records will be obtained via the regional offices of Clalit Health Services and analyzed in order to learn the effects of mind-body therapies on health care utilization. 2. A prospective study of new patients arriving at the "functional neurology" clinic at Soroka UMC. Members of the second arm will be asked if they would be willing to participate in the study by their neurologist. Participants who have agreed to join the study will fill out Self-report measures at the beginning of their treatment, at the end of treatment (3 months) and 6 months after the start of treatment and 12 months after the start of treatment. Expected Results 1. A decrease in expense rates and use of medical services 2. An increase in patient satisfaction 3. An increase in patient-reported health and quality of life
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Medical and psychological treatment by the staff of the "functional neurology" clinic at Soroka UMC. This treatment will include an initial visit to the staff neurologist and further multidisciplinary treatment as per his decision (the team includes a psychologist and a physical therapist).
Soroka University Medical Center
Beersheba, Israel
Health Related Quality of Life
Changes in the Short Form 36 Health Survey (SF-36)
Time frame: 6 months
Cost-effectiveness
Total cost associated with healthcare due to intervention
Time frame: 12 months
Anxiety
Changes in the State-Trait Anxiety Inventory (STAI)
Time frame: 6 months
Depression
Changes in the Patient Health Questionnaire 9 (PHQ-9)
Time frame: 6 months
Catastrophization
Changes in the Pain Catastrophization Scale (PCS)
Time frame: 6 months
Locus of Control
Changes in the Health Locus of Control Survey (H-LOC)
Time frame: 6 months
Existence of Symptoms
Changes in the Patient Health Questionnaire 15 (PHQ-15)
Time frame: 6 months
Pain Symptoms and Functioning
Changes in the Short Form Treatment Outcomes in Pain Survey (S-TOPS)
Time frame: 6 months
Patient Satisfaction with Medical Care
Changes in the Low Threshold Experience Survey (LTES)
Time frame: 6 months
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