Integrated Care for Patients with Somatic Symptom Disorder in Primary Care – A Qualitative Participatory Evaluation... 2023 Tönnies et al

Andy

Andy

Retired committee member
Full title:
Integrated Care for Patients with Somatic Symptom Disorder in Primary Care – A Qualitative Participatory Evaluation of a Randomised Feasibility Trial

Objective
The VISION intervention is a manualized short-term treatment for people with somatic symptom disorder, integrated into the primary care and delivered by psychotherapists via video consultations. As an innovative technology-based approach, the intervention was most recently piloted in a randomized feasibility trial. During the qualitative accompanying study presented here, the intervention was evaluated and optimised from the user perspective of patients who participated in the feasibility study.

Methods
We interviewed a total of N=10 patients included in the intervention group in three semi structured focus group discussions focusing on how they (1) assess the intervention in terms of acceptance and individual benefit and (2) which adjustments are necessary from the user perspective for further optimization of the intervention. We performed a qualitative content analysis using MAXQDA Plus 2022.

Results
Respondents reported initial reservations on their part regarding care via video consultation. After a brief period of habituation, the intervention was universally accepted. Main suggestions for improvement included a stronger focus on supporting patients find follow-up psychotherapy (if indicated) more flexible settings (e. g., location of video consultation), and a stronger integration of treatment into primary care.

Discussion and conclusion
The study provides systematically elaborated comprehensive findings on participants’ practical experiences with the intervention. The model is appropriate for treating people with somatic symptom disorder. Before implementation, important suggestions for improvement should be thoroughly considered with continued patient and public involvement.

Paywall, https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2105-3402
 
Andy said:
Full title:
Integrated Care for Patients with Somatic Symptom Disorder in Primary Care – A Qualitative Participatory Evaluation of a Randomised Feasibility Trial

Objective
The VISION intervention is a manualized short-term treatment for people with somatic symptom disorder, integrated into the primary care and delivered by psychotherapists via video consultations. As an innovative technology-based approach, the intervention was most recently piloted in a randomized feasibility trial. During the qualitative accompanying study presented here, the intervention was evaluated and optimised from the user perspective of patients who participated in the feasibility study.

Methods
We interviewed a total of N=10 patients included in the intervention group in three semi structured focus group discussions focusing on how they (1) assess the intervention in terms of acceptance and individual benefit and (2) which adjustments are necessary from the user perspective for further optimization of the intervention. We performed a qualitative content analysis using MAXQDA Plus 2022.

Results
Respondents reported initial reservations on their part regarding care via video consultation. After a brief period of habituation, the intervention was universally accepted. Main suggestions for improvement included a stronger focus on supporting patients find follow-up psychotherapy (if indicated) more flexible settings (e. g., location of video consultation), and a stronger integration of treatment into primary care.

Discussion and conclusion
The study provides systematically elaborated comprehensive findings on participants’ practical experiences with the intervention. The model is appropriate for treating people with somatic symptom disorder. Before implementation, important suggestions for improvement should be thoroughly considered with continued patient and public involvement.

Paywall, https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2105-3402
Click to expand...

Ya, but no evidence of patients not having the 'disorder' afterwards.

So what was the point?
 
Yeah, where is the therapeutic benefit?

Respondents reported initial reservations on their part regarding care via video consultation. After a brief period of habituation, the intervention was universally accepted.

There may be other ways to interpret that.
 
I don't trust anything coming from a focus group in this sort of situation. It's far to easy for the person leading it to use leading questions and to direct the discussion away from anything negative, and to focus discussion on positive aspects. An anonymous questionnaire with open ended questions would be better.
 
The paper said:
The model is appropriate for treating people with somatic symptom disorder. Before implementation, important suggestions for improvement should be thoroughly considered with continued patient and public involvement.
Click to expand...
From "it's appropriate in a limited setting" to "let's implement this far and wide once we fix a few things" is just ridiculous. This is completely unserious, there is zero consideration for efficacy, and even the comments basically amount to "yeah it could be OK if it was otherwise". Out of N=10. Even by pseudoscientific standards this is laughable, there is zero effort at even appearing to be legitimate.

They're actually showing that they don't care one bit if it does anything. This is actually a lower standard than alternative medicine, where people don't come back to your business if they only find it "acceptable" with caveats that basically amount to "uh, but shouldn't there also be a doctor in involved?" Here they have a captive market that doesn't have anywhere else to go to. It's disgusting how little respect they have for the patients.

And it's not "based" on technology, it's delivered through technology. It's a medium, as valid as saying that astrology is technology-based because there are TV and Internet psychics. And the comment about "location of TV consult" suggests that this is done using equipment at some clinic, rather than at home, which entirely negates the point of being remote, and likely is what the comment is about.

Even homeopaths try harder than this. Not much, but still.
 
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