My symptoms
The treatment programme My Symptoms is an internet‐based self‐help programme targeting adult patients with persistent physical symptoms (PPS) in primary care.
Project timeline: 2018-2028
Background
Stepped care
International guidelines for the management of PPS recommend a stepped care approach to address the entire severity spectrum of PPS: 1) Patients with self-limiting symptoms should be managed by general practitioners (GPs) in routine care; 2) patients with PPS should be offered specific treatment by GPs in close collaboration with specialists if necessary; and 3) patients with functional disorders should be offered specialised treatment. Although this stepped care model is recommended, it lacks sufficient implementation especially for patients with PPS. Many GPs find the management of patients with PPS challenging and time-consuming, and patients are often left with insufficient explanations for their symptoms and an inadequate symptom management plan. Furthermore, only a minority of patients with PPS receive specialised treatment due to very limited capacity in specialised care.
MANAGEMENT OF PERSISTENT PHYSICAL SYMPTOMS IN GENERAL PRACTICE
General practice is the first point of contact in many European healthcare systems and hence responsible for the initial treatment of PPS. Cognitive behavioural therapy (CBT) and graded activity training have proven effective treatments of PPS. However, these treatments rely on specially trained healthcare professionals (e.g. mental health specialists and physiotherapists) and are often more time-consuming than usual consultations in general practice.
eHEALTH - A VIABLE SOLUTION?
Self-help interventions with minimal support by healthcare professionals may be a viable solution to provide improved and evidence-based treatment for early stage PPS in primary care. Technological advances allow for new delivery methods that diminish the financial and logistic barriers and support the provision of treatment services that are otherwise accessible only in specialised care settings.
The My Symptoms Programme
My Symptoms targets patients with PPS. The programme is inspired by cognitive behavioural therapy and provides psychoeducation and modules on the impact of lifestyle, stress and strain, thoughts, feelings, values, and self-care (see Figure 1).
The programme content is presented in various formats such as text, illustrations, figures, interactive exercises, audio, and animated videos.
Throughout the programme, two core interactive tools support behaviour change with embedded examples on how to use these tools in all modules. These tools (Don't break the chain and Goal ladder) are available from the right-hand side of the dashboard (Figure 1).
Various resources are available from the left hand-side menu such as help, programme overview, and a library with exercises.
