Multiple Symptoms Study 3
Research type
Research Study
Full title
Multiple Symptoms Study 3: pragmatic trial of a community based clinic for patients with persistent (medically unexplained) physical symptoms
IRAS ID
232038
Contact name
Christopher Burton
Contact email
Sponsor organisation
NHS Sheffield Clinical Commissioning Group
ISRCTN Number
ISRCTN57050216
Duration of Study in the UK
3 years, 5 months, 31 days
Research summary
Research Summary
Persistent (“medically unexplained”) physical symptoms affect around 1 million people (2% of adults) in the UK. They affect patients’ quality of life and account for at least one third of referrals from GPs to specialists. Current models of healthcare which focus on detecting disease do not help patients make sense of their persistent symptoms and there is little evidence to guide practice outside of specialised psychological settings.
The Symptoms Clinic is a series of psychologically-informed medical consultations which have gone through several stages of development and piloting. They are delivered by an extended role GP who have received specialist training. COnsultations are designed to allow patients to describe the nature and impact of their symptoms and help them find new ways of understanding and managing those symptoms drawing on current scientific knowledge. Each patient receives one 50 minute consultation and up to three structured 15 minute follow-ups.
Preliminary studies suggest that the Symptoms Clinic is capable of producing clinically important short-term improvements in patients’ symptoms. This current study, Multiple Symptoms Study 3, is a randomised controlled trial designed to test the longer term clinical and cost-effectiveness of the intervention and to understand how, if effective, it can be delivered in routine care.
Summary of Results
Why did we do this study?
1 in 50 UK adults regularly has multiple symptoms which make life difficult for them. These persistent physical symptoms include pain, fatigue, dizziness, stomach problems and many others. Because medical tests don’t show a cause for persistent physical symptoms, doctors often don’t know how to help and patients can feel no-one believes them. We developed a way of using new scientific knowledge about symptoms to help people make sense of their own symptoms and to try new things to help. We tested this in a Symptoms Clinic. We wanted to know if patients found a difference one year later.Who completed the research?
Multiple Symptoms Study 3 was led by health researchers at the University of Sheffield. The study was sponsored by South Yorkshire Integrated Care Board (previously known as NHS Sheffield Clinical Commissioning Group) and was funded by the National Institute of Health Research, part of the NHS.What did we do?
354 people with persistent physical symptoms joined the study between December 2018 and December 2021. Half of them had up to 4 appointments at the Symptoms Clinic, while the other half got their usual care. We asked people in both groups to complete some questionnaires about their symptoms and health and its impact on their daily life. These questionnaires were completed at the start of the study and after 3, 6 and 12 months and compared the two groups. We also listened to what happened in the clinic by recording the symptoms clinic consultations and interviewed some people to find out what it was like.What did we find?
276 participants completed the questionnaires at the 12-month follow up. Our results showed that people who attended the Symptoms Clinic found it gave them better ways to understand and manage their symptoms. A year after they joined the study, people who had attended the Symptoms Clinic had less symptoms bothering them than those who hadn’t. They also had a better quality of life. The interviews showed us that patients who attended the Symptoms Clinic found it acceptable.
We looked at the costs of the Symptoms Clinic and we found that it is likely to be a cost-effective addition to patient’s current usual care.We also collected data about the safety of the intervention. There was no evidence to suggest that the Symptoms Clinic caused any harm to patients.
What does this mean for people with persistent physical symptoms?
Explaining physical symptoms in this way can make a real difference for patients. This research shows us how health professionals can do it well and the difference it can make.How can I find out more?
If you would like to find out more please visit the MSS3 website: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQ25rsCM5rYLXTMRP8UYA5HW4ju17PtIVusG7YRcGNuVl2VTl-2BZf7sbpwhd4a9w-2BSA-3D-3D4Kkj_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YKf0LvIS-2BxMuL37er30uyQyvbbK6n6OPowQZ2e8sMk-2FQc7nRYgKvafXykjpwzzqaKg5N-2FFQYs83BppAwhwff-2Fa-2BZq-2BUk322KV3ueMKtWCVhjgG4c3Wa5-2Bybh-2BSm5FGMMU7jDcxbROlooAZ2PU30jwvP59c-2F87NAWeWbLGfkI4uTug-3D-3D&data=05%7C02%7Cgmcentral.rec%40hra.nhs.uk%7C2fd75f316f2749ea141008dc224c4992%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638422958257947226%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=WHq654y7oNcXY6VF9MFRbUNOFBxOp69wSR3KwKL9AC8%3D&reserved=0
We will keep this website update to date with publications and other information about the study.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
18/NW/0422
Date of REC Opinion
26 Jun 2018
REC opinion
Favourable Opinion