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BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Experiences of general practitioner continuity among women with chronic fatigue syndrome/myalgic encephalomyelitis: a cross-sectional study

Authors: Anne Helen Hansen, Olaug S. Lian

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Continuity of care is important for patients with chronic illness in need of coordinated healthcare services from multiple providers. Little is known about how patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) experience continuity of GP care.
This study explores how women with CFS/ME experience GP care across the three dimensions of continuity: informational, management, and relational continuity.

Methods

This cross-sectional study uses questionnaire data collected from members of The Norwegian ME Association. Descriptive statistics and logistic regressions were used to estimate experiences of continuity, and associations with age, education, self-rated degree of CFS/ME, duration of the GP relation (GP duration), and number of GP visits for CFS/ME-related issues during the previous year (GP frequency).

Results

Almost two-thirds of participants reported positive experiences across all three dimensions of GP continuity of care; 64.4% for informational, 64.1% for management, and 77.2% for relational continuity. Lower educational attainment was associated with more negative experiences of informational continuity (primary school only compared to university educated: odds ratio [OR] 0.12, confidence interval [CI] 0.03–0.49, p = 0.003). Compared to participants aged 40–59 years, those aged 60+ years were significantly less likely to have experienced poor (negative) management continuity (OR 0.25, CI 0.09–0.76, p = 0.014). A GP relationship of three or more years was associated with positive experiences of relational continuity (OR 2.32, CI 1.09–4.95, p = 0.030). Compared to those with moderate CFS/ME, those who graded their CFS/ME as severe or very severe were significantly more likely to have negative experiences of relational continuity (OR 0.38, CI 0.14–0.99, p = 0.047).

Conclusions

A large proportion of participants experienced all three aspects of continuity of GP care (especially the relational dimension) positively. Informational and management continuity scores were moderately lower. Our results suggest greater emphasis on information giving, feedback, and better coordination of care to be good strategies for practice improvement for this patient group.
Appendix
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Literature
1.
Brurberg KG, Fonhus MS, Larun L, Flottorp S, Malterud K. Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review. BMJ open. 2014;4(2):e003973.CrossRefPubMedPubMedCentral
2.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121(12):953–9.CrossRefPubMed
3.
Hairon N. NICE guidance on managing chronic fatigue syndrome/ME. Nurs Times. 2007;103(39):21–2.
4.
Fluge O, Bruland O, Risa K, Storstein A, Kristoffersen EK, Sapkota D, et al. Benefit from B-lymphocyte depletion using the anti-CD20 antibody rituximab in chronic fatigue syndrome. A double-blind and placebo-controlled study. PLoS One. 2011;6(10):e26358.CrossRefPubMedPubMedCentral
5.
Bakken I, Tveito K, Gunnes N, Ghaderi S, Stoltenberg C, Trogstad L, et al. Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008 inverted question mark2012. BMC Med. 2014;12(1):167.PubMedPubMedCentral
6.
Prins JB, van der Meer JW, Bleijenberg G. Chronic fatigue syndrome. Lancet. 2006;367(9507):346–55.CrossRefPubMed
7.
Capelli E, Zola R, Lorusso L, Venturini L, Sardi F, Ricevuti G. Chronic fatigue syndrome/myalgic encephalomyelitis: an update. Int J Immunopathol Pharmacol. 2010;23(4):981–9.CrossRefPubMed
8.
Lian OS, Nettleton S. "United We Stand": Framing Myalgic Encephalomyelitis in a Virtual Symbolic Community. Qual Health Res. 2015;25(10):1383–94.
9.
Horton SM, Poland F, Kale S, Drachler Mde L, de Carvalho Leite JC, et al. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adults: a qualitative study of perspectives from professional practice. BMC Fam Pract. 2010;11:89.CrossRefPubMedPubMedCentral
10.
Woodward RV, Broom DH, Legge DG. Diagnosis in chronic illness: disabling or enabling--the case of chronic fatigue syndrome. J R Soc Med. 1995;88(6):325–9.PubMedPubMedCentral
11.
Bowen J, Pheby D, Charlett A, McNulty C. Chronic Fatigue Syndrome: a survey of GPs' attitudes and knowledge. Fam Pract. 2005;22(4):389–93.CrossRefPubMed
12.
Chew-Graham C, Dowrick C, Wearden A, Richardson V, Peters S. Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study. BMC Fam Pract. 2010;11:16.CrossRefPubMedPubMedCentral
13.
Werner A, Malterud K. It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Soc Sci Med. 2003;57(8):1409–19.CrossRefPubMed
14.
Anderson VR, Jason LA, Hlavaty LE, Porter N, Cudia J. A review and meta-synthesis of qualitative studies on myalgic encephalomyelitis/chronic fatigue syndrome. Patient Educ Couns. 2012;86(2):147–55.CrossRefPubMed
15.
16.
17.
18.
Hansen AH, Halvorsen PA, Aaraas IJ, Forde OH. Continuity of GP care is related to reduced specialist healthcare use: a cross-sectional survey. Br J Gen Pract. 2013;63(612):482–9.CrossRefPubMed
19.
20.
Aboulghate A, Abel G, Elliott MN, Parker RA, Campbell J, Lyratzopoulos G, et al. Do English patients want continuity of care, and do they receive it? Br J Gen Pract. 2012;62(601):e567–575.CrossRefPubMedPubMedCentral
21.
O'Connor PJ, Desai J, Rush WA, Cherney LM, Solberg LI, Bishop DB. Is having a regular provider of diabetes care related to intensity of care and glycemic control? J Fam Pract. 1998;47(4):290–7.PubMed
22.
23.
Cabana MD, Jee SH. Does continuity of care improve patient outcomes? J Fam Pract. 2004;53(12):974–80.PubMed
24.
Lian OS, Wilsgaard T. Patient satisfaction with primary health care before and after the introduction of a list patient system. Tidsskr Nor Laegeforen. 2004;124(5):655–8 (in Norwegian).PubMed
25.
Lian OS, Hansen AH. Factors facilitating patient satisfaction among women with medically unexplained long-term fatigue: A relational perspective. Health (London, England: 1997) 2015.
26.
Hansen AH, Lian OS. How do women with chronic fatigue syndrome/myalgic encephalomyelitis rate quality and coordination of healthcare services? A cross-sectional study. BMJ Open. 2016;6(4):e010277.CrossRefPubMedPubMedCentral
27.
Babyak MA. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med. 2004;66(3):411–21.PubMed
28.
Carruthers BM, van de Sande MI, De Meirleir KL, Klimas NG, Broderick G, Mitchell T, et al. Myalgic encephalomyelitis: International Consensus Criteria. J Intern Med. 2011;270(4):327–38.CrossRefPubMedPubMedCentral
29.
Deale A, Wessely S. Patients' perceptions of medical care in chronic fatigue syndrome. Soc Sci Med. 2001;52(12):1859–64.CrossRefPubMed
30.
Aelbrecht K, Rimondini M, Bensing J, Moretti F, Willems S, Mazzi M, et al. Quality of doctor-patient communication through the eyes of the patient: variation according to the patient's educational level. Adv Health Sci Educ Theory Pract. 2015;20(4):873–84.CrossRefPubMed
31.
Raivio R, Jaaskelainen J, Holmberg-Marttila D, Mattila KJ. Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care - a 14-year follow-up questionnaire study. BMC Fam Pract. 2014;15:98.CrossRefPubMedPubMedCentral
32.
Ali FM, Nikoloski Z, Reka H. Satisfaction and responsiveness with health-care services in Qatar-evidence from a survey. Health Policy. 2015;119(11):1499–505.
33.
Van Den Assem B, Dulewicz V. Doctors' trustworthiness, practice orientation, performance and patient satisfaction. Int J Health Care Qual Assur. 2015;28(1):82–95.CrossRef
34.
Trentman TL, Chang YH, Chien JJ, Rosenfeld DM, Gorlin AW, Seamans DP, et al. Attributes associated with patient perceived outcome in an academic chronic pain clinic. Pain Pract. 2014;14(3):217–22.CrossRefPubMed
35.
Poot AJ, den Elzen WP, Blom JW, Gussekloo J. Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems. PLoS One. 2014;9(4):e94326.CrossRefPubMedPubMedCentral
36.
Hekkert KD, Cihangir S, Kleefstra SM, van den Berg B, Kool RB. Patient satisfaction revisited: a multilevel approach. Soc Sci Med. 2009;69(1):68–75.CrossRefPubMed
37.
Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open 2013, 3(1). doi: 10.​1136/​bmjopen-2012-001570.
38.
Heje HN, Vedsted P, Sokolowski I, Olesen F. Patient characteristics associated with differences in patients' evaluation of their general practitioner. BMC Health Serv Res. 2008;8:178.CrossRefPubMedPubMedCentral
39.
Gladwell PW, Pheby D, Rodriguez T, Poland F. Use of an online survey to explore positive and negative outcomes of rehabilitation for people with CFS/ME. Disabil Rehabil. 2014;36(5):387–94.CrossRefPubMed
40.
41.
42.
Comiskey C, Larkan F. A national cross-sectional survey of diagnosed sufferers of myalgic encephalomyelitis/chronic fatigue syndrome: pathways to diagnosis, changes in quality of life and service priorities. Ir J Med Sci. 2010;179(4):501–5.CrossRefPubMed
Metadata
Title
Experiences of general practitioner continuity among women with chronic fatigue syndrome/myalgic encephalomyelitis: a cross-sectional study
Authors
Anne Helen Hansen
Olaug S. Lian
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1909-1

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