[Hardnekkige aanhoudende lichamelijke klachten in de huisartsenpraktijk].

Abstract

Background: In the care of patients with persevering (‘treatment-resistant’) persistant physical symptoms (PPS), problems are common. With this study, we want to identify starting points for improvement of care, including suggestions for the role of mental health care.

Aim: Using the profile for persevering PPS we will estimate the prevalence, describe characteristics of this patient group and map problems encountered in their care.

Method: Online survey in general practitioners (GPs).

Results: The response rate to the survey was 12.8%. The mean estimated prevalence of persevering PPS in general practice was 0.7% (corresponding to an estimated 122,500 patients throughout the Netherlands). Many patients encountered iatrogenic harm, experience societal problems and limitations in mobility and ADL independence. Although there was a general increased use of health care in these patients, some also avoided care or were under-treated. In the persistence of symptoms, patient-related factors played a role (like insisting on further somatic diagnostic tests, lack of motivation for PPS-specific treatment), but health-care related factors, like rejection for care or a lack of regional treatment options for patients with PPS, also had a causal role.

Conclusion: Almost every GP experiences problems in the care for patients with persevering PPS. Mental health care professionals can support the GP better, by optimizing options for consultation and referral.