Abrahamsen Cathrine, Wangen Knut Reidar, Lindbaek Morten, Werner Erik Lønnmark
Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
BJGP Open. 2025 Jan 2;8(4). doi: 10.3399/BJGPO.2024.0004. Print 2024 Dec.
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.
DESIGN & SETTING: 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, = 0.014). Receiving long-term benefits predicted improved PGIC in both the unadjusted (OR 2.30, 95% CI = 1.21 to 4.39, = 0.011) and adjusted models (OR 2.46, 95% CI = 1.04 to 5.83, = 0.040). In addition, living alone predicted reduced sick leave in the adjusted model (OR 3.23, 95%CI = 1.11 to 9.42, = 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.
持续性身体症状（PPS）在初级保健患者中一直很普遍。PPS会对生活质量、医疗成本和工作参与产生负面影响。在之前的一项研究中，我们发现，与对照组相比，使用一种名为个人挑战清单工具（ICIT）的以工作为重点的沟通工具治疗的患者，其治疗效果有显著改善，病假天数减少。
研究由患者的全科医生提供ICIT治疗的患者治疗效果的预测因素。
本研究基于我们之前在挪威进行的整群随机对照试验的结果。
对干预组进行回归分析，以确定在11周随访后患者总体变化印象（PGIC）改善和病假天数减少的预测因素（均在基线时测量）。
在调整后的模型中，独居可预测改善情况（比值比[OR]为4.03，95%置信区间[CI]=1.33至12.25，P=0.014）。在未调整模型（OR为2.30，95%CI=1.21至4.39，P=0.011）和调整后模型（OR为2.46，95%CI=1.04至5.83，P=0.040）中，领取长期福利均与PGIC改善相关。此外，在调整后的模型中，独居可预测病假天数减少（OR为3.23，95%CI=1.11至9.42，P=0.032）。
总体而言，几乎没有因素可预测以工作为重点的沟通工具的治疗效果。因此，我们建议这种以工作为重点的沟通工具适用于大多数PPS患者。全科医生可考虑对所有在日常生活和工作中表现出无效应对策略的初级保健患者使用ICIT，尤其是独居患者。
