How should a patient with health anxiety be monitored?

From the Guidelines

Patients with health anxiety should be monitored through regular follow-up appointments with healthcare providers, typically on a monthly basis or until symptoms have subsided, as recommended by 1. These appointments should include assessment of follow-through and compliance with individual or group psychological or psychosocial referrals, as well as satisfaction with the treatment, as suggested by 1 and 1. Key aspects to monitor include:

• Compliance with pharmacologic treatment, patient’s concerns about adverse effects, and satisfaction with symptom relief, as outlined in 1 and 1.
• Progress with exposure exercises and cognitive restructuring techniques for those undergoing cognitive behavioral therapy (CBT), as implied by the treatment approaches discussed in 1 and 1.
• Self-monitoring of reassurance-seeking behaviors, body checking, and internet searching for health information, which is crucial for managing health anxiety, as can be inferred from the discussion on treatment strategies in 1 and 1.
• Monitoring for changes, including new or worsening symptoms and the effects of these on the person’s life and wellbeing, as recommended by 1, which is the most recent and highest quality study. The frequency and method of monitoring (in-person or remotely) should be tailored to the person’s symptoms and preferences, as suggested by 1. This comprehensive monitoring approach is essential for maintaining the therapeutic relationship, which is crucial for treatment adherence and effectiveness in managing health anxiety, as implied by the emphasis on ongoing assessment and follow-up in 1, 1, and 1.

From the Research

Monitoring a Patient with Health Anxiety

To monitor a patient with health anxiety, the following steps can be taken:

• Regular check-ins with the patient to assess their anxiety levels and concerns 2
• Collaboration with primary care physicians to ensure comprehensive care 3, 4
• Use of validated clinical rating scales to track symptoms and progress 5
• Provision of cognitive-behavioral therapy (CBT) elements, which have been shown to be effective in reducing health anxiety 2, 3, 6
• Monitoring of medication use and adjustment of treatment plans as needed 3, 6

Effective Care Models

Effective care models for patients with health anxiety include:

• Integrated care models that combine primary care with specialized mental health services 5
• Task-shifted interventions, where medical assistants or other healthcare professionals deliver psychosocial interventions 2
• Video-based consultations, which can increase access to specialized care and improve patient outcomes 5

Challenges and Barriers

Challenges and barriers to effective care for patients with health anxiety include:

• Difficulty engaging patients in evidence-based psychosocial interventions 2
• Limited access to specialized mental health services 3, 4
• Underuse of cognitive-behavioral therapy (CBT) and other effective treatments 3, 6
• Variability in quality of care across different primary care settings 3, 6