Videofragment Wim Brandsen - Tim Parks

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1 Videofragment Wim Brandsen - Tim Parks Fragment: minuut

2 Blended training helps medical specialists in communication with patients with Medically Unexplained Physical Symptoms Dr. Anne Weiland MUPS research & training Department Internal Medicine & Department General Practice Erasmus MC, University Medical Center Rotterdam

3 Prevalence new MUPS pt (n=550), Nimnuan, Wessely, 2001 Outpatient Clinic Prevalence (95% CI) Chest 41% (28-53) Rheumatology 45% (35-55) Cardiology 53% (43-63) Gastroenterology 58% (44-71) Neurology 62% (52-72) Gynaecology 66% (56-76)

4 Prevalence MUPS in Emergency Department Alsma J, Van de Wouw J, Jellema K, Coffeng S, Tobback E, Delesie L, Van den Brand C, Vogelaers D, Mariman A, De Paepe P, Van Saase J, Weiland A. Medically Unexplained Physical Symptoms in Patients Visiting the Emergency Department; An International Multicenter Retrospective Study Submitted.

5 2004 by BMJ Publishing Group Ltd Neurologists find MUPS consultations difficult, Carson 2004

6 Explaining functional disorders, Carson et al. Pract Neurol 2016;16:56-61

7 MUPS - research & training in specialist care ( ) Weiland A, Van de Kraats RE, et al. Encounters between medical specialists and MUPS patients; influences of communication on patient outcomes and use of healthcare: a literature review. Perspect Med Educ.2012;1: Review Pilot Training 14 hrs face to face In 4 sessions RCT 123 doctors 478 patients

8 Trained doctors explore more effectively Weiland A, Blankenstein AH, Van Saase JLCM, et al. Training medical specialists to communicate better with MUPS patients; a RCT PLoS ONE 10(9):e doi:10.137/journal.pone

9 Trained doctors inform more effectively Weiland A, Blankenstein AH, Van Saase JLCM, et al. Training medical specialists to communicate better with MUPS patients; a RCT PLoS ONE 10(9):e doi:10.137/journal.pone

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11 Advantages Blended Learning, Dankbaar et al Higher level at start trainingsession Flexibility in learning Tailored learning Use of multimedia is motivating Standard content Online courses have no limits in numbers of participants Less productivity loss for doctors Less cotrainers needed -> cheaper

12 Structure Blended MUPS training From 14 hours in 4 sessions -> 8 hours in 2 sessions + 6 hours online

13 E-module on reassurance & discussing expectations

14 Test results Blended MUPS training (n=18)

15 Doctors evaluated both training models positively Content Length Feedback Useful! 2.8 Original training (n=92) 2.8 Blended training (n=44) 3-pnt scale (SE=0,18 ;1=min - 3=max) Weiland A, Blankenstein AH et al. Postgraduate education for medical specialists focused on patients with MUPS. Patient Educ Couns 92 (2013)

16 I am glad I could help Thank you so much, it feels like I am finally making progress!

17 Transcultural communication and MUPS

18 Better exchange of information needed Weiland A, Blankenstein AH, Willems MHA, Van Saase JLCM, Van Daele PLA, Bootsma A, Vriens EM, Oberndorff-Klein Woolthuis A et al. Training medical specialists to write appropriate reply letters to GPs about patients with MUPS; a cluster randomized trial. Patient Educ Couns 98 (2015) reply letters specialist -> GP % Pre Contr. % Pre Interv. % Post Contr. % Post Interv. Referral question GP mentioned Answered GP s referral Q Questions of patient mentioned Answered patient s Q * 63* Somatic findings mentioned Additional investigations mentioned Explanation MUPS mentioned Advice to patient and GP mentioned

19 Take home messages Blended learning in training MUPS communication skills works! Online courses serve the face-to-face training when doctors are absent. Transcultural MUPS communication needs our attention! Cooperation between primary and specialist MUPS care is vital.

20 Thanks for your attention Thanks to teamwork: Prof. Dr. Jan van Saase, Department of Internal Medicine Erasmus MC, Rotterdam, NL Prof. Dr. Sandra van Dulmen, NIVEL and Department of Primary and Community Care Radboud University Medical Center, Nijmegen, NL Prof. Dr. Lidia Arends, Department of Psychology, Education & Child studies, Faculty of Social Sciences, Erasmus University Rotterdam, NL Dr. Mary Dankbaar, programme manager e-learning Erasmus MC, Rotterdam, NL Dr. Els Vriens, Department of Neurology Diakonessenhuis, Utrecht, NL