Cyberchondria - costing the NHS millions

[slysaint]

Various news items on this.

http://www.telegraph.co.uk/news/201...g-anxiety-epidemic-clogging-hospital-clinics/

"'Cyberchondria' fuelling anxiety epidemic clogging up hospital clinics
""Cyberchondria" is fuelling an epidemic of health anxiety, with one in five NHS appointments taken up by hypochondriacs and those with irrational fears, experts have warned.

Researchers from Imperial College London said internet searching and the use of fitness trackers is heaping pressures on busy hospital clinics.

Health anxiety is estimated to cost the NHS more than £420 million a year in outpatient appointments alone, with millions more spent on needless tests and scans, they warned.

Instead, such cases should be offered a course of counselling, psychiatrists said, following a five-year study of patients treated in five English hospitals."


http://www.bbc.co.uk/news/health-41176729

"Useful therapy
In their study, published in the National Institute for Health Research journal, they found that cognitive behavioural therapy (CBT) sessions were much more effective at improving health anxiety than standard care, and the benefits lasted for up to five years.

They tracked 444 patients with severe health anxiety from five hospitals in England.

Nurses were just as good at delivering CBT as trained psychologists and doctors, the study suggested."

The link to the study goes to here:
https://www.journalslibrary.nihr.ac.uk/hta/hta21500/#/
"
Cognitive behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years
In medical outpatients with high health anxiety, CBT led to bigger improvements than standard care in health anxiety and these improvements were maintained over five years of follow-up."


The CBT Empire is expanding.

eta: 1 in 5 appts are cyberchondriacs, does this include the figure for MUS, suspected neurological disorders and all the other stuff they propose to prescribe CBT for (I've lost track of all the acronyms)?

 

[Esther12]

So in a trial with 444 participants (after 28,991 were screened) there was no significant difference between groups on healthcare spending. Yet the Guardian headline was "Tackling health anxiety could save NHS over £400m a year, study finds" https://www.theguardian.com/society...over-400m-a-year-study-finds?CMP=share_btn_tw

Total costs were similar in both groups over the 5-year period (£12,590.58 for CBT-HA; £13,334.94 for standard care). CBT-HA was not cost-effective in terms of quality-adjusted life-years, as measured using the EQ-5D, but was cost-effective in terms of HAI outcomes, and offset the cost of treatment.

https://www.journalslibrary.nihr.ac.uk/hta/hta21500/#/abstract

 

[A.B.]

The message seems to be along the lines of "those dang cyberchondriacs are ruining the NHS for the good honest folk". So nothing to do with government policies, neoliberalism, quack treatments like CBT draining money or anything like that.

 

[keenly]

Various news items on this.

http://www.telegraph.co.uk/news/201...g-anxiety-epidemic-clogging-hospital-clinics/

"'Cyberchondria' fuelling anxiety epidemic clogging up hospital clinics
""Cyberchondria" is fuelling an epidemic of health anxiety, with one in five NHS appointments taken up by hypochondriacs and those with irrational fears, experts have warned.

Researchers from Imperial College London said internet searching and the use of fitness trackers is heaping pressures on busy hospital clinics.

Health anxiety is estimated to cost the NHS more than £420 million a year in outpatient appointments alone, with millions more spent on needless tests and scans, they warned.

Instead, such cases should be offered a course of counselling, psychiatrists said, following a five-year study of patients treated in five English hospitals."


http://www.bbc.co.uk/news/health-41176729

"Useful therapy
In their study, published in the National Institute for Health Research journal, they found that cognitive behavioural therapy (CBT) sessions were much more effective at improving health anxiety than standard care, and the benefits lasted for up to five years.

They tracked 444 patients with severe health anxiety from five hospitals in England.

Nurses were just as good at delivering CBT as trained psychologists and doctors, the study suggested."

The link to the study goes to here:
https://www.journalslibrary.nihr.ac.uk/hta/hta21500/#/
"
Cognitive behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years
In medical outpatients with high health anxiety, CBT led to bigger improvements than standard care in health anxiety and these improvements were maintained over five years of follow-up."


The CBT Empire is expanding.

eta: 1 in 5 appts are cyberchondriacs, does this include the figure for MUS, suspected neurological disorders and all the other stuff they propose to prescribe CBT for (I've lost track of all the acronyms)?

Pure rubbish.

 

[NelliePledge]

perhaps we should rename PR Cyberchondriacs Anonymous

how dare we go on line to educate ourselves about our disease when we should be relying on the truth and wisdom of the psychs

 

[Snowdrop]

Instead of them getting out their pitchforks and torches maybe they might consider working with companies to make the wearable technology better to the point that it is very useful data for the doctors when the patient presents. That means getting better/deeper data and knowing how to interpret it. It would actually save money in the end I think.

 

[Undisclosed]

"Cyberchondria" is fuelling an epidemic of health anxiety, with one in five NHS appointments taken up by hypochondriacs and those with irrational fears, experts have warned.

Researchers from Imperial College London said internet searching and the use of fitness trackers is heaping pressures on busy hospital clinics.

Health anxiety is estimated to cost the NHS more than £420 million a year in outpatient appointments alone, with millions more spent on needless tests and scans, they warned.

Instead, such cases should be offered a course of counselling, psychiatrists said, following a five-year study of patients treated in five English hospitals.

Read rest of the article here.

 

[Alvin2]

I don't buy it, 1 in 5, that makes little sense, now if they said 1 in 5 go for colds/flu i would be more (opposite of skeptical).
Besides death is not the only result of illness, if people starting losing limbs for example they would probably live yet not be counted...

 

[TiredSam]

Cyberchondria sounds like a word invented purely to facilitate dismissal of any patient who informs themself and asks questions. The British love jumping on board with a new word like this which labels a social stereotype and sticks the boot in. Now we are all cyberchondriacs and the press is playing along as usual.

How can you have informed patient consent if patients are to be belittled when they inform themselves? Unless "informed patient" means informed by their doctor and nobody else.

 

[Chrisb]

This seems to be one of those issues where the press likes to have it both ways.

Another favourite is always the story of the person turned away by hospital or GP, told to take paracetamol, and dead within hours.

 

[Sean]

Wessely has been banging on for years about the 'dangers' of internet-induced mass hysteria.

 

[Skycloud]

Back in 1977 my dad had health anxiety. He was diagnosed by the GP with malingering. Worried and unsatisfied, my mum went into town on the bus to the library and correctly ascertained that the malingering was infact bibliochondria (every bit as real a word as cyberchondria). She even pinpointed what kind of bibliochondria it was. Thanks to my mum, my dad's bibliochondria, along with his piturity gland, was removed at The John Radcliffe Hospital in Oxford. Radiotherapy followed. He was not only grateful to them for saving his life he was also very proud that he had become a guineapig.

Fast forward to the 1990's. My son would periodically vomit what was diagnosed by his paediatrician as attention seeking. He also implied a diagnosis for myself of health anxiety by proxy. Fortunately my son was given a new diagnosis of severe cross reactive nut allergy by someone who actually believed in allergies. Unfortunately my health anxiety by proxy persisted right through my son's rather gung-ho teens.

Fast forward again, this time to 2013. My mum developed health anxiety and IBS (which we know is a psychosomatic illness). 2 night time trips of medical attention seeking and several GP appointments ensued.

Nine months later, the GP, concerned at the weight she had lost from sheer worry, and perhaps also bowing to my own ever troublesome health anxiety by proxy, referred my mum to a gastroenterologist. Because they could immediately see the very obvious health anxiety in my mum's pelvic cavity on the MRI scan, they admitted her into hospital the same afternoon.

I've run out of sarcastic humour now. My mum was told that they suspected uterine cancer. It appeared from the scans that her whole abdominal cavity might be effected. In extremely fragile health she lived with that tentative diagnosis for 6 weeks while the hospital tried to clear her bowel and coordinate 4 surgeons with different specialisms to be available at the same time.

It wasn't cancer, but an extensive infection due to historical intestinal abcess and scarring in her pelvic and abdominal cavity. She is extremely lucky to be alive, and to have all her internal organs and to be enjoying mostly good health at the age of 73. I believed she was going to die she was so ill.

Thanks to the health anxiety by proxy, and having to care for my mum, I crashed to housebound.

I have no patience with this at all.

How many of those 'time wasting' visits that they dismissively label 'cyberchondria' were part of a bigger story, as my own family have experienced? They do not know, because their research doesn't cover it.

 

[arewenearlythereyet]

It's amazing that they have managed to also slip in that the psychiatrists won't need to get their hands dirty, implementing this sinister plan...even silly nurses can do the CBT for them!

They really are out of the ark in their thinking aren't they? This sort of dismissive talk by consultants does go on in healthcare system to this day but it is now a lot rarer than in used to be. I think most people recognise that nurses and junior doctors should not be treated as low life's to do the consultants bidding....well I hope it's improved since the 1950's at least.

I think it would be good training for the psychiatrists to have a once per year unpaid stint in A&E as a porter just so they can have a little taste of reality to temper their more outlandish thinking. Either that or sack the lot of them and replace their salaries with the equivalent of nurses and doctors?

 

[Skycloud]

I think it would be good training for the psychiatrists to have a once per year unpaid stint in A&E as a porter just so they can have a little taste of reality to temper their more outlandish thinking. Either that or sack the lot of them and replace their salaries with the equivalent of nurses and doctors?

I think it would be better training for them to, for a year, have the same condition as they treat/research just so they can have a little taste of reality to temper their more outlandish thinking.

I think I've recovered my inner bolshy.

 

[slysaint]

From Panorama last night:
http://www.bbc.co.uk/news/health-41204389
"One in four NHS hospital trusts is failing to give antibiotics to half their patients with sepsis within the recommended time, new figures suggest."

Each year, sepsis claims around 31,000 lives and costs the NHS in England about £2 billion.(5 Jan 2015)

Saw this last night; although the patients were not diagnosed with 'cyberchondria', a lot of them died or it was too late to stop the disease spreading before they received any diagnosis at all.

This health anxiety stuff can only make situations like this worse.

 

[Murph]

I dunno but where I live they're trying to encourage men to go to the doc if they think they're ill. This is the sort of thing that leaves people at home wondering if they're crook right up until they start shitting blood.

 

[Sean]

I don't dismiss the possibility of 'health anxiety', but what it is crystal clear is that medicine cannot yet safely diagnosis it in the individual, and are very unlikely to be able to do so any time soon, if ever.

Until they can reliably rule out underlying organic disease this nonsense should be kept right out clinical and policy decisions.

 

[arewenearlythereyet]

I think it would be better training for them to, for a year, have the same condition as they treat/research just so they can have a little taste of reality to temper their more outlandish thinking.

I think I've recovered my inner bolshy.

Welcome back

 

[A.B.]

Psychobabblemania: a state of excitement and excessively high self esteem where the person believes they possess special insight into the psyche and perceives it as playing a central etiological role in disease. The afflicted person views themselves as genius or specially gifted and perceives disagreement as evidence of intellectual or moral inferiority. The afflicted person will begin drawing up vague illness models that supposedly explain how psychological factors cause disease and attempt to convince everyone around them. A characteristic avoidance behaviour is also seen in regards to verifying the validity of such models or debate with critics.

Risk factors: being exposed to psychoanalysis at a young age, training as psychologist or psychiatrist, working in the area of medico-legal questions or for a health insurance company, impaired ability to reason about evidence and causality, cocaine abuse.

I can make up words and diagnoses too.

 

[chipmunk1]

Cyberchondria is the fear that a patient could become informed by accessing the internet.

My impression is that most cyberchondriac patients experience the symptoms first and start to worry later and consult Dr. Google looking for answers.