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Healthcare experiences of people living with medically unexplained symptoms: a systematic review

07 March 2024
Volume 33 · Issue 5


A diagnosis of medically unexplained symptoms (MUS) is made when a person reports a complaint for which no organic disease can be detected. People with MUS commonly present to primary care services in the UK; however, there is no consensus regarding the evidence base for care. This literature review explores the experiences of these patients when they interact with health services. The following themes emerged: experience of diagnosis; expectations; communication; and healthful relationships. People with MUS report negative experiences of health care. Nurses in primary care have an opportunity to provide person-centred care to support these patients, and research could explore the potential contribution of nurses working in primary care in the UK to support them and enhance the evidence base for practice.

Medically unexplained symptoms (MUS) is an umbrella term (Lidén and Yaghmaiy, 2017; Jones, 2019) that is often applied when people present with heterogeneous symptoms for which no organic disease can be detected (Murray et al, 2013). The explanation or lack thereof for MUS is paradoxical as diagnosis often arises because an alternative explanation is absent (Murray et al, 2013). Approximately 20% of new primary care consultations in the UK are cases of MUS, rising to approximately 52% of new referrals to secondary care (Jadhakhan et al, 2019). Individuals often have a history of multiple diagnoses (Nunes et al, 2013).

In the UK, there are no overarching National Institute for Health and Care Excellence (NICE) pathways or Scottish Intercollegiate Guidelines Network guidelines for MUS or associated physical or functional disorders. NICE provides links to related resources while NHS Education for Scotland (2020) and the Scottish Government (2024) have produced learning materials and policies to improve practice regarding conditions with commonalities with MUS.

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