The effect of a multi-disciplinary integrative intervention on health status and general health perception in primary care frequent attenders.

Abstract

The objective of this study was to assess the effect of a biopsychosocial intervention on patients' feelings of well-being, perceptions of health and health indicators before and after treatment in a clinic for primary care frequent attenders. One hundred patients referred to a community-based clinic were assessed using the WONCA-COOP charts and MOS-SF36 questionnaires before and after treatment with an intervention consisting of a narrative interview, short-term cognitive-behavioral therapy, stress reduction techniques and medication. Sixty-three out of 100 patients who completed the COOP charts at intake completed them again at follow-up and 35 patients out of 40 who completed the MOS-SF36 at intake completed them at follow-up. Statistically significant improvement was noted in five out of six categories on the COOP charts ("physical fitness" "emotions", "social function", "daily activity" and "general health status") and in four out of eight categories of the MOS ("emotional health", "physical health", "social functioning", and "pain"). We concluded that in this uncontrolled study, a biopsychosocial intervention produced a positive effect on function and self-perception of health in a group of frequent attenders from primary care.

Health benefits of primary care social work for adults with complex health and social needs: a systematic review

“…The majority investigate interventions by social workers; two examine a multidisciplinary intervention (Matalon et al . , ) and three interventions target psychosocial morbidity and subjective health, health behaviour and medical compliance (Rock & Cooper , Matalon et al . , ).…”

“…Four studies specified a theoretical orientation (Rock & Cooper , Matalon et al . , , Firth et al . ) and one described the choice of setting – a practice in a disadvantaged neighbourhood (Rock & Cooper ) – as congruent with ‘the core social work mission’.…”

“…In the studies by Matalon et al . (, ), frequent‐attender patients identified by their GPs as ‘difficult’ were referred to a multidisciplinary community intervention, the Comprehensive Consultation Clinic. Patients had an average of 10 chronic symptoms and 87% had a diagnosis of somatisation.…”

Toward Optimal Health: Discussing the Role of Prevention in the Care of Women

“…Yet, all patients deserve to hear from knowledgeable providers that what they do on a daily basis affects their chronic disease risk. 3,10,14 Women, therefore, should be educated about the fundamentals of healthful eating and reminded about the negative impact of smoking, and they deserve good guidance about the right level of physical activity needed to promote health. 6,12,13,[15][16][17] Beyond that, there is an important role for clinicians as agents of health-promoting changes to stand behind a cultural shift-advocating for positive community offering, such as daily physical activity in schools and nutrient-dense school meals.…”

“…Scientific evidence exists for some complementary and alternative therapies (CAM), but for most, rigorous clinical trials have not been done and are unlikely, given the high cost and lack of incentives to do so. 9,10 In effect, there is a built-in limitation to achieving an evidence basis in an integrative medicine model similar to that of conventional medicine. Therefore, moving into the realm of CAM, it is important to remain open to the possible benefits and potential efficacy of strategies for an individual patient.…”