A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome.
OBJECTIVE
Our aim was to evaluate the effect of an educational program designed to improve care for somatizing patients in primary care.


METHODS
Evaluation was performed during routine clinical care in a cluster randomized controlled trial. Patients were included consecutively, and those with a high score on rating scales for somatization were selected for follow-up (n=911). Follow-up was conducted 3 months (response rate=0.74) and 12 months (response rate=0.69) after inclusion using questionnaires measuring quality of life (Medical Outcomes Study 36-Item Short Form), disability days (WHO's Disability Assessment Schedule), somatization (Whiteley-7 and Symptom Checklist Somatic Symptom Scale) and patient satisfaction (European Project on Patient Evaluation of General Practice Care). We analyzed differences from baseline to follow-up and compared these for intervention and control groups.


RESULTS
Self-reported health improved in both intervention and control groups during follow-up for patients with a high score for somatization, but changes were small. We could not demonstrate any difference between the control group and the intervention group with regard to our primary outcome 'physical functioning.' Patients in the intervention group tended to be more satisfied at 12-month follow-up than those in the control group, but this difference fell short of statistical significance.


CONCLUSIONS
Training of primary care physicians showed no statistically significant effect on clinical outcome and showed nonsignificant improvement in patient satisfaction with care for patients with a high score for somatization.
Rosendal
Marianne
M
The Research Unit for General Practice, University of Aarhus, DK-8000 Aarhus, Denmark. m.rosendal@dadlnet.dk
Olesen
Frede
F
Fink
Per
P
Toft
Tomas
T
Sokolowski
Ineta
I
Bro
Flemming
F
D000328:Adult; D003718:Denmark; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000628:therapy*; D011795:Surveys and Questionnaires; D013663:Teaching