Photo Credit: Stokkete

The following is a summary of “Explaining persistent physical symptoms to patients in general practice: can tests to measure central sensitisation add value? A mixed-methods study,” published in the December 2024 issue of Primary Care by Boer et al. 

General practitioners (GPs) face challenges explaining persistent physical symptoms (PPS) to patients. Although central sensitization (CS) may be a key factor, GPs rarely test for CS in these patients. 

Researchers conducted a retrospective study to explore the value of testing for CS in enhancing explanations for patients with PPS. 

They carried out a prospective study with 25 GPs who used 3 tests to assess CS-related symptoms: the Central Sensitization Inventory (CSI), an algometer for pressure pain thresholds (PPT), and a monofilament for temporal summation. Following the tests, both GPs and patients completed questionnaires. GPs discussed their experiences in focus groups and interviews, while patients were interviewed individually. The questionnaires underwent quantitative analysis, while the focus groups and interviews were analyzed qualitatively. 

The results showed that all tests were feasible during consultations, with 25% taking less than 5 minutes and 60% taking 5 to 10 minutes. In 50% of cases, an additional consultation was needed. The CSI confirmed CS-related symptoms in 74% of cases, more frequently than the algometer (46%) and monofilament (43%). As a result, many GPs preferred the CSI and 2/3 of patients found the tests valuable. Approximately 50% reported that CS explanations were clearer with a test. 

Investigators found testing for CS feasible, with 50% requiring an additional consultation. GPs preferred the CSI, as it confirmed CS-related symptoms more often. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02686-w