Table II.

Included studies: GP-related phenomena associated with sick leave.

First author, year, country [reference]	Aim	Study design	GP-related phenomena	Quality of paper
Schilte, 2001, Netherlands [24]	To evaluate a disclosure intervention among somatizing patients. Sick leave was one outcome	RCT (n =161). 9 other GP offices served as an extra control-group	The intervention did not reduce the sick leave but seemed to impact negatively	S
Larisch, 2005, Germany [26]	To evaluate the cost effects of specialized psychosocial training of GPs working with somatizing patients. Sick leave was an indirect cost	RCT (n =20 GPs/73 patients in the intervention group versus 17 GPs/54 patients in the control group)	No significant difference in costs related to sick leave days.	S
Rosendal, 2007, Denmark [23]	To evaluate the effect of an educational programme (TERM) where one outcome was disability days	RCT (n =43 GPs, 911 somatizing patients)	Disability days decreased by 1.7 days in the control group and increased by 1.0 day in the intervention group, but the results were not significant (p =0.212)	S
Ringsberg, 2006, Sweden [21]	To elucidate GPs’ perception of MUS patients, focusing on stressing situations, emotional reactions, and coping strategies	Focus-group discussion, 5 groups, total of 27 GPs. Tape-recording, verbatim typewritten, phenomenographic approach	GPs issued a sickness certificate when they felt “stuck” and felt they needed a “breathing space” from the patient	S
Woivalin, 2004, Sweden [22]	To explore GPs’ perceptions and ways of managing patients with MUS	The same focus groups as Ringsberg (ref [21])	Findings of a pathological test, even subtle, eased the assessment of sick-listing the patient. They were aware of medicalization when accepting psychosocial problems as cause for sick leave as they needed to label the symptoms as a disease	M
Nilsen, Norway, 2011 [14]	To explore GPs’ considerations in decision-making regarding sick-listing of patients suffering from subjective health complaints	Focus-group discussion, 9 groups, total of 48 GPs. Tape-recording, verbatim typewritten, systematic text condensation	Factors described to ease assessment of sick leave: finding of an objective sign, seeing a clear purpose of sickness certificate, an established good therapeutic relationship based on prior knowledge, trust and sympathy	S