Abstract Body

Experiences of GPS explaining central sensitization to patients with persistent physical symptoms

Objective

It is important for patients with persistent physical symptoms (PPS) to get an acceptable explanation for their symptoms. Central sensitization (CS) is an explanatory model for PPS and chronic pain in, amongst others, physiotherapy and rehabilitation medicine, but until now it is not often used by general practitioners (GPs). We aimed to assess the role of CS as explanatory model both on GPs and on patients.

Methods

We trained 33 GPs with their mental health nurse practitioners and (psychosomatic) physiotherapists. We gave a short training in explaining CS. We provided training materials like videos, drawings, an educational paper and books. After 0.5-1.5 year applying the model, 26 GPs participated in focus groups and interviews to report and discuss their experiences with and thoughts on CS as explanatory model. Next to that, we organized a multidisciplinary focus group with experts. Audio recordings were transcribed and thematically analysed.

Results

The model provided tools and insight for both GP and patient. GPs concluded that the CS explanation was acceptable for patients and helped them to get motivated for treatment. They indicated that they were struggling with the fear to miss somatic pathology. Sometimes they considered explaining the model rather challenging. Experts reported positive effects of the explanation on patients and rated the model high.

Conclusion

Though the model is complex and the issue of diagnostic uncertainty remains, it offers tools and insight for both patient and GP. Furthermore, it increases motivation for accepting treatment in patients, possibly leading to reduction of symptoms.