The NHS could save close to half a billion pounds a year by recognising the growing level of health anxiety fuelled by “cyberchondria”, or people obsessively researching their own medical symptoms online.
A five-year study at five English hospitals has found that busy waiting rooms are often clogged by people with the condition, as up to 20% of treatment in accident and emergency departments, GP surgeries and out-patient clinics is for people who have searched online and wrongly convinced themselves they have serious medical problems.
The resulting anxiety is distressing patients and costing the NHS more than £420 million a year in unnecessary outpatient appointments, plus tens of millions more in needless tests and scans.
Researchers at Imperial College London, King’s College London and other centres said the phenomenon is also fed by people using fitness trackers to monitor their own bodies for symptoms and diseases, piling extra demand on cardiac clinics and neurology units
Lead author Professor Peter Tyrer said using “Dr Google” to search online for information about medical conditions often convinced people they had exaggerated or unusual medical conditions.
“People now go to their GPs with a whole list of things they’ve looked up on the internet and say ‘what do you make of this?’, and the poor GP, five minutes into the consultation, has four pages of reading to do.
“Dr Google is very informative but he doesn’t put things in the right proportion,” said Tyrer, a professor of community psychiatry at Imperial.
Relying On Dr Google
Health anxiety often hit people who had earlier suffered a genuine health scare or it could be triggered by seeing a family member falling ill or even the death of a celebrity the same age as the patient.
“After apparently successful treatment of heart attacks people would interpret minor symptoms as warnings of further attacks, cut down on all their activities, create more suffering and have their lives thrown into chaos and disarray.”
“With the ready availability of the internet, people feel it’s their responsibility to look after their health, and indeed, public health experts encourage this.”
Tyrer said patients tended to ignore the word “rare” when researching and diagnosing themselves online.
A google search will often produce details about “a serious disease which is very rare, but unfortunately the health anxious patient … thinks: “I’m the one in the 1,000”.’
Funded by the National Institute for Health Research, the study urged the NHS to recognise health anxiety as a common condition and concluded that the National Institute for Health and Care Excellence (Nice) should produce guidelines to manage it.
Relatively cheap psychological treatment could help people suffering from severe health anxiety who can otherwise receive unnecessary and expensive treatments by cardiology, gastroenterology, neurology and respiratory departments.
A trial of cognitive behaviour therapy had extremely positive results and there was no evidence of the reduced levels of anxiety leading to genuine health conditions being overlooked.
The researchers called on doctors to be more aware of the possible psychological cause of a patient’s complaints, and suggested that nurses were just as good at delivering CBT as trained psychologists and doctors.
Tyrer said the psychological treatment “allows therapists with no previous experience to be trained relatively easily. It therefore has the potential to be used widely in general hospital settings under appropriate supervision.”
Yvonne Lisseman Stones, a general nurse at Sherwood Forest Hospitals NHS foundation trust, said delvering the treatment as part of the project was the most satisfying experience of her 40-year career, “simply because it changes lives”.
“One of my patients had stopped all physical activity because of severe health anxiety, but after therapy was able to climb Mount Snowdon, where he wrote to me and said ‘thank you for making me feel on top of the world’.”
by Peter Wilson
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