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Mental health
Protocol
Prevalence of medically unexplained symptoms in adults who are high users of health care services: a systematic review and meta-analysis protocol
  1. Ferozkhan Jadhakhan1,2,
  2. Oana C Lindner3,
  3. Amy Blakemore4,
  4. Elspeth Guthrie3
  1. 1School of Psychology, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, UK
  2. 2Research and Innovation, Birmingham and Solihull Mental Health NHS Foundation Trust, The Barberry, Research and Innovation, Edgbaston, Birmingham, West Midlands, United Kingdom
  3. 3Division of Psychological and Social Medicine, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
  4. 4Division of Nursing, Social Work and Midwifery, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Ferozkhan Jadhakhan; F.Jadhakhan{at}bham.ac.uk

Abstract

Introduction Medically unexplained symptoms (MUS) are common in primary-care and secondary-care settings. Persistent symptoms of MUS are associated with a variety of poor outcomes including increased disability, poor quality of life and high healthcare costs. The aim of this systematic review is to review the relevant literature to determine the prevalence of MUS in patients who are high users of healthcare and/or who accrue high healthcare costs.

Methods and analysis This review will include studies with cases that are either high users of general healthcare or are patients who accrue high healthcare costs, aged ≥18 years and where a recognised measure of MUS, either a standardised clinical interview or questionnaire, was employed. The following citation databases MEDLINE, PsycINFO, EMBASE, CINAHL, PROSPERO and the Cochrane library will be systematically searched from inception to 30 June 2018. The Cochrane library was included because of the significant proportion of non-observational studies currently published in the database. The prevalence of MUS and associated disorders along with the costs or use of healthcare associated with the presence of MUS will be estimated with 95% CI. If possible, study results will be pooled into a meta-analysis. However, if heterogeneity is high, data analysis will be presented descriptively.

Ethics and dissemination Ethical approval is not required for this systematic review since only data from existing studies will be used. Results of this review will be disseminated in peer-reviewed publications and at national and international conferences.

PROSPERO registration number CRD42018100388

  • medically unexplained symptoms
  • health care utilisation
  • high cost
  • high health care cost
  • frequent attenders
  • primary care
  • secondary care
  • prevalence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-027922

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    Footnotes

    • Contributors FJ and OCL developed the search strategy. FJ drafted the manuscript and registered the protocol. EG and AB were involved in the design of the review and provided continuous feedback on the manuscript. FJ will be first reviewer and OCL will be second reviewer. All authors read and approved the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.

    • Patient consent for publication Not required.