Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: A meta synthesis of qualitative studies

Kerin Bayliss, Mark Goodall, Anna Chisholm, Beth Fordham, Carolyn Chew-Graham, Lisa Riste, Louise Fisher, Karina Lovell, Sarah Peters, Alison Wearden

    Research output: Contribution to journalArticlepeer-review

    Abstract

    The NICE guideline for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) emphasises the need for an early diagnosis in primary care with management tailored to patient needs. However, GPs can be reluctant to make a diagnosis and are unsure how to manage people with the condition.

    Methods
    A meta synthesis of published qualitative studies was conducted, producing a multi-perspective description of barriers to the diagnosis and management of CFS/ME, and the ways that some health professionals have been able to overcome them. Analysis provided second-order interpretation of the original findings and developed third-order constructs to provide recommendations for the medical curriculum.

    Results
    Twenty one qualitative studies were identified. The literature shows that for over 20 years health professionals have reported a limited understanding of CFS/ME. Working within the framework of the biomedical model has also led some GPs to be sceptical about the existence of the condition. GPs who provide a diagnosis tend to have a broader, multifactorial, model of the condition and more positive attitudes towards CFS/ME. These GPs collaborate with patients to reach agreement on symptom management, and use their therapeutic skills to promote self care.

    Conclusions
    In order to address barriers to the diagnosis and management of CFS/ME in primary care, the limitations of the biomedical model needs to be recognised. A more flexible bio-psychosocial approach is recommended where medical school training aims to equip practitioners with the skills needed to understand, support and manage patients and provide a pathway to refer for specialist input.
    Original languageEnglish
    Article number44
    JournalBMC Family Practice
    Volume15
    Issue number1
    DOIs
    Publication statusPublished - 7 Mar 2014

    Keywords

    • Barriers and facilitators
    • Chronic fatigue syndrome/ME
    • Management and diagnosis
    • Primary health care
    • Qualitative research

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