Polysymptomatic Patients: A Two-centre Outcome Audit Study

Abstract

Consecutive polysymptomatic patients managed by two environmental medical regimes were sent the same questionnaire, asking about degree of life disruption, change in condition, and the frequency and severity of 64 symptoms. Patients had been treated in the Airedale Allergy Centre (AAC) or in Cambridge. Patients (total 369) had had symptoms for a median of < 10 years with two previous consultant referrals each (range 0–10), and were highly polysymptomatic on presentation but not on follow-up (FU). Severe and frequent symptoms had fallen from five to one per patient (medians) for the AAC series at 6–30 months, and from eight to one for the Cambridge series at 3–8 years, p < 0.0001 for each. Of each group, about 70% were 'Frequently incapacitated' or 'Struggled to keep going' on presentation, but only 10–13% on FU (p < 0.0001). More than 35% were 'Well' or 'Almost well' on FU, and over half were not using any medication, regularly or occasionally. The questionnaire and method were validated by high correlations among the AAC patients between answers to the same questions given (1) independently by patients and relatives, (2) by different cohorts, and (3) at the time of admission and retrospectively, and by correlations between the answers to the different questions. The patients treated at the AAC and in Cambridge showed similar responses although over different time-scales. The majority had improved substantially, and attributed their improvement to the type of management.