Innovait, the journal for Associates in Training (AiTs) of the Royal College of General Practitioners has published an article on Chronic Fatigue Syndrome emphasising the role of GPs in making an early diagnosis and giving management advice for CFS It rejects the classification of CFS as neurological and talks of people with a history of chronic fatigue as having mental health problems.
GPs are encouraged to:
- ‘take a detailed bio-psychosocial history to identify potential perpetuating factors and highlight the patient’s expectations and goals’
- ‘check for psychological illness while avoiding the habit of checking extensively for physical illness’
- avoid ‘multiple inappropriate referrals to specialist medical clinics’
- ‘show that you believe them’
- ‘address early a patient’s ability to continue in work and education’
- ‘concentrate on managing symptoms and improving function’
- advise patients not ‘to undertake unsupervised, or unstructured, vigorous activity, such as simply ‘go to the gym’ or ‘exercise more’
- ‘advise patients to limit rest periods to 30 minutes at a time to avoid prolonged bed rest’
- encourage patients in relapse to ‘maintain activity and exercise levels during such setbacks. It is doubtful whether such patients will benefit from further specialist input.’
- advise that ‘CBT and GET can be used safely and that CBT and GET are more effective treatments than APT or specialist medical care’
- help them apply for ‘appropriate equipment and adaptations’
- ‘make sure patients are receiving their full benefit entitlement’
- refer children ‘to a paediatric service (after symptoms have been present for 6 weeks).
Read WAMES’ response to the Innovait guidelines
