Multiple Symptoms Study 3
Multiple Symptoms Study 3: Pragmatic trial of a community based clinic for patients with persistent (medically unexplained) physical symptoms
Update July 2024
We are pleased to announce that the results of the MSS3 study are now available. We found that the Symptoms Clinic led to a significant reduction in multiple and persistent physical symptoms and that this effect persisted at 9–10 months after the intervention. Thank you to all those who took part in the study.
The full results are published in the Lancet, alongside an editorial and review article.
Burton C, Mooney C, Sutton L, et al. Effectiveness of a symptom-clinic intervention delivered by general practitioners with an extended role for people with multiple and persistent physical symptoms in England: the Multiple Symptoms Study 3 pragmatic, multicentre, parallel-group, individually randomised controlled trial.
Lancet. 2024 Jun 15;403(10444):2619-2629. doi: 10.1016/S0140-6736(24)00700-1. PMID: 38879261.
The Lancet. Taking persistent physical symptoms seriously.
Lancet. 2024 Jun 15;403(10444):2565. doi: 10.1016/S0140-6736(24)01242-X. PMID: 38879240.
Löwe B, Toussaint A, Rosmalen JGM, et al. Persistent physical symptoms: definition, genesis, and management.
Lancet. 2024 Jun 15;403(10444):2649-2662. doi: 10.1016/S0140-6736(24)00623-8. PMID: 38879263.
Multiple Symptoms Study 3 is a large randomised controlled trial to test the effectiveness of a Symptoms Clinic for people with persistent “medically unexplained” physical symptoms.
Background
Persistent physical symptoms (which cannot be adequately attributed to physical disease) affect around 1 million people (2% of adults) in the UK. They affect patients’ quality of life and account for at least one-third of referrals from GPs to specialists. These referrals give patients little benefit but have a real cost to health services in terms of time and diagnostic resources. When patients are told that medical tests do not show a cause for their symptoms they are commonly disappointed in their interactions with clinicians.
We know that patients with symptoms want to have those symptoms explained in acceptable ways in order to know that their symptoms are legitimate, and find ways to adapt to them and manage them. Without explanation, many patients seek further healthcare use while at the same time losing confidence that it will help them.
The Symptoms Clinic
The Symptoms Clinic is a set of up to four medical appointments designed to help people make sense of persistent physical symptoms (especially if medical tests have been negative) and to reduce the impact of symptoms on daily life. Consultations will take place via video link with a doctor who has had special training for the Symptoms Clinic Intervention.
The consultations include detailed medical history taking, explanation (including discussion of appropriate diagnosis) and advice about management. The Symptoms Clinic involves an initial long consultation of approximately 50 minutes followed up by two or three medium-length consultations of 15-20 minutes.
Study update
The study is currently in follow up.
Project team
If you have any questions about MSS3 please contact the Trial Manager, Cara Mooney: C.D.Mooney@Sheffield.ac.uk
| Name | Role | Site |
|---|---|---|
| Professor Chris Burton | Chief Investigator | Academic Unit of Primary Medical Care, University of Sheffield |
| Cara Mooney | Trial Manager | Clinical Trials Research Unit, University of Sheffield |
| Professor Vincent Deary | Co-investigator | Northumbria University, Newcastle |
| Professor Jeremy Dawson | Trial Statistician | School of Health and Related Research, University of Sheffield |
| Professor Gillian Rowlands | Principal Investigator | Newcastle University |
| Dr Ruth Thomas | Co-investigator | University of Aberdeen |
| Professor Cindy Cooper | Director, Clinical Trials Research Unit | Clinical Trials Research Unit, University of Sheffield |
| Professor Monica Greco | Co-investigator | Goldsmiths, University of London |
| Dr Tom Sanders | Co-investigator | Northumbria University, Newcastle |
| Aileen Neilson | Co-investigator | The University of Edinburgh |
| David White | Co-investigator | Clinical Trials Research Unit, University of Sheffield |
| Dr Steve Thomas | Co-Investigator | NHS Sheffield Clinical Commissioning Group |
| Dr Michelle Horspool | Sponsor Representative | NHS Sheffield Clinical Commissioning Group |
| Dr Waquas Waheed | Principal Investigator | The University of Manchester |
| Laura Sutton | Trial Statistician | Clinical Trials Research Unit, University of Sheffield |
| Emily Turton | Trial Data Manager | Clinical Trials Research Unit, University of Sheffield |
| Rowena Seaton Kelly | Trial Support Officer | Clinical Trials Research Unit, University of Sheffield |
Funder
This project is funded by the National Institute for Health Research, Health Services and Delivery Research (NIHR HS&DR) Programme (project number 15/136/07).
Sponsor
NHS Sheffield Clinical Commissioning Group.
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