Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care

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Nico Vanden Eynde posted this to co-cure today

(if: my bolds and spacing. I'm glad the GPs were being honest. But how frightening that in 2010 they do not know how to define or diagnose ME/CFS and that they think that "their role in making a diagnosis was to exclude physical causes for the patient's symptoms,"

BMC Family Practice 2010, 11:16doi:10.1186/1471-2296-11-16

Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study

Carolyn Chew-Graham , Christopher Dowrick , Alison Wearden , Victoria Richardson and Sarah Peters

Published: 23 February 2010

C2010 Chew-Graham et al. , licensee BioMed Central Ltd

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Abstract (provisional)

Background

NICE guidelines emphasise the role of the primary care team in the
management of patients with Chronic Fatigue Syndrome/Myalgic Encephalitis
(CFS/ME). A key stage in effective management is making an accurate early
diagnosis, supported by appropriate referral.

Methods

A nested qualitative study within a multi-centre randomised controlled trial
[ISRCTN 74156610] which aimed to explore GPs' views on their role in making
the diagnosis of CFS/ME and subsequent management of patients in primary
care. Semi-structured interviews with 22 GPs. Interviews were transcribed
verbatim and an iterative approach used to develop themes from the dataset.

Results

GPs described difficulties in defining CFS/ME

and suggested that their role in making a diagnosis was to exclude physical causes for the patient's
symptoms
,


but they reported little confidence in positively attributing the label of CFS/ME to a patient and their symptoms.

GPs suggested that the label of CFS/ME could be potentially harmful for the patient.

The role of referral to secondary care was debated and GPs struggled defining their own
role in management of this group of patients.

Conclusions

Until GPs feel comfortable making the diagnosis of CFS/ME and facilitating
initial management,


and have appropriate services to refer patients to,

there will continue to be delays in confirming the diagnosis and patients
presenting in primary care with fatigue may not receive appropriate care.


Trial Registration: ISRCTN74156610

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Full-Text article at:
http://www.cfsresearch.org/cfs/research/diagnosis/11.htm