Impact of an Intervention with a Narrative Approach in Overusers: a Clinical Trial

Catalan Institute of Health

Status: Enrolling

Conditions: Overuse Syndrome

Treatments: Other: Intervention with a narrative approach.

Study type: Interventional

Funder types: Other

Identifiers

NCT06258512

CatalanIH

Details and patient eligibility

About

The goal of this clinical trial is to compare an intervention with a narrative therapy-based approach with standard care in overusers in general practice . The main question it aims to answer are:

• An intervention with an approach based on narrative therapy can improve the perception of emotional support, and reduce the probability of suffering from anxiety and/or depression, the number of consultations, and the number of medications in primary care overusers.

Participants will 10 individual sessions carried out over five months. The interval between sessions will be two weeks with a specific duration of fifty minutes per session..

If there is a comparison group: Researchers will compare two groups of overusers to see if reduces the number of visits to the primary care doctor.

Full description

Background: The best treatment for the excessive use of the consultation is currently being discussed.

Hypothesis: An intervention with an approach based on narrative therapy, compared to standard care, leads to reducing psychosocial distress and reducing the number of consultations with the family doctor.

Objective: To evaluate the effectiveness of an intervention based on co-constructing a new narrative of symptoms of non-organic origin compared to usual clinical care, with respect to affective social support, the probability of suffering from anxiety and/or depression, and the use of the medical consultation.

Methodology: Pragmatic, controlled and randomized, non-masked clinical trial. Study subjects: 264 users (132 in each group, intervention and control) with excessive use of the consultation (95th percentile of the distribution of appointment-type and/or urgent visits to the medicine service). Intervention will be compared with narrative approach + standard care / standard care.

Determinations: Symptoms of anxiety and depression, social support, number of consultations, age, sex, marital status, educational level, income level, employment status.

Statistical analysis: In order to determine the discriminant capacity of the variables associated with the intervention, we will build a multiple regression model in which we will include those that were statistically significant in the bivariate analysis and those that are relevant according to the bibliography.

Expected results: The results will provide evidence on the effectiveness of said intervention.

Application and Relevance: This type of intervention would most likely reduce the pressure on medical-health professionals.

Enrollment: 264 estimated patients

Sex: All

Ages: 25 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Users in the 95th percentile in the distribution of consultations face-to-face, patient self-initiated consultations with PHC services within the period of 1 year.

Exclusion criteria

• Drug abuse or dependence, except for nicotine and tetrahydrocannabinol.
• Comorbidity with DSM-IV-TR (American Psychiatric Association, 2000) severe mental disorders.
• Comorbidity with ICD-10 (World Health Organization, 2008) severe cognitive disorders or sensory disabilities.
• Major locomotor mobility limitations or terminal illness

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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264 participants in 2 patient groups

Intervention with narrative approach + standard care

Experimental group

Description:

Intervention with a narrative approach. The objectives will be: 1. Know significant moments in the personal history of the participant and her family according to her life cycle. as well as structural elements. 2. Know information regarding symptoms of non-organic origin, pain crises, personal and family resources for their management. 3. Implement a narrative technique as an alternative for the management of symptoms of non-organic origin, including the following strategies: the participant will be able to tell and retell their story, recognize situations or moments that exacerbate the pain, feel the pain and name it, externalization of the pain. problem, the problem is the problem, absolving oneself from traumatic life experiences, constructing meaning to one\'s dominant stories through the organization of the experience, to obtain a new meaning of what was experienced through the story, construction of alternative stories.

Treatment:

Other: Intervention with a narrative approach.

control with standard care

No Intervention group

Description:

Participants randomly assigned to the control group will receive usual care from their primary care professionals.