title: Experiences of general practitioner continuity among women with chronic fatigue syndrome/myalgic encephalomyelitis: a cross-sectional study.
abstract: 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.
  
  
  
  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).
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Faculty of Health Sciences, Department of Community Medicine, University of Tromsø - The Arctic University of Norway, 9037, Tromsø, Norway. anne.helen.hanzen@gmail.com.|University Hospital of North Norway, PO box 35, 9038, Tromsø, Norway. anne.helen.hanzen@gmail.com.
authors.forename: Anne Helen
authors.identifier: 0000-0001-7396-0879
authors.initials: AH
authors.lastname: Hansen
authors.affiliation: Faculty of Health Sciences, Department of Community Medicine, University of Tromsø - The Arctic University of Norway, 9037, Tromsø, Norway.
authors.forename: Olaug S
authors.initials: OS
authors.lastname: Lian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards*; D003430:Cross-Sectional Studies; D015673:Fatigue Syndrome, Chronic / Q000628:therapy*; D005260:Female; D058006:General Practice / Q000592:standards*; D006296:Health Services / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009664:Norway; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME); Continuity of patient care; Cross-sectional study; General practitioner; Norway; Primary health care