Bayliss, K, Goodall, M, Chisholm, A, Fordham, B, Chew-Graham, CA, Riste, L, Fisher, L, Lovell, K, Peters, S and Wearden, A (2014) Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: a meta synthesis of qualitative studies. BMC Familty Practice, 15. 44 -?.

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Abstract

Background
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.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BioMed Central at http://dx.doi.org/10.1186/1471-2296-15-44 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: chronic fatigue syndrome/ME, barriers and facilitators, management and diagnosis, qualitative research, primary health care
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 06 Apr 2017 13:28
Last Modified: 20 May 2019 12:52
URI: http://eprints.keele.ac.uk/id/eprint/3192

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