Facilitators and barriers to implementing the management of medically unexplained symptoms in primary care: A scoping review based on the updated consolidated framework for implementation research

Background Patients with medically unexplained symptoms (MUS) account for a high proportion of general practice consultation. It is difficult to make a definite diagnosis, thus limiting treatment strategies for the cause; however, primary care services should include specific response strategies. Objective To explore the facilitators and barriers of management of MUS patients in primary care facilities, and provide suggestions for further improvement. Methods Based on the updated Consolidated Framework For Implementation Research (CFIR) system, the facilitators and barriers mentioned in existing studies were reviewed and analyzed. Results A total of 16 studies were included. Facilitators included positive attitudes of both patients and general practitioners (GPs), and the GPs serve as the first contact for care. Barriers included the complexity of the innovation, lack of guidelines, difficulties in doctor-patient communication, and insufficient GP competencies. Conclusion Implementing the management of MUS in primary care involves multiple levels of influencing factors. Future research should be grounded in primary care practice in China and take advantage of local training policies and specific service models. Through coordinated efforts across the policy, community, and individual levels, the diagnosis and management of these patients in primary care can be more effectively promoted.