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Patient and primary care practitioners' perspectives on consultations for fibromyalgia: a qualitative evidence synthesis

Byrne, Ailish; Jones, Katherine; Backhouse, Michael; Rose, Fiona; Moatt, Emma; van der Feltz-cornelis, Christina; (2023) Patient and primary care practitioners' perspectives on consultations for fibromyalgia: a qualitative evidence synthesis. Primary Health Care Research & Development , 24 , Article e58. 10.1017/S1463423623000506. Green open access

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Abstract

Background: Fibromyalgia presents a challenge to both the patients experiencing symptoms and the staff aiming to treat them. This qualitative review aimed to synthesise how patients and practitioners experience primary care consultations, develop a rounded picture of how they perceive each other, the challenges to primary care consultation and how they might be tackled. Methods: CINAHL, Embase, CENTRAL and Medline were searched from inception to November 2021. Qualitative studies were included if they explored the perspectives and experiences of either fibromyalgia patients or primary care practitioners. Quantitative data, studies not published in English, not set in primary care or that did not distinguish the type of patient or clinician were excluded. Included studies were analysed using thematic synthesis and their quality assessed. Results: In total, 30 studies met the inclusion criteria. Thematic synthesis identified three overarching themes: (1) life turned upside down - exploring the chaos experienced by patients as they seek help; (2) negative cycle - highlighting how patient and practitioner factors can create a detrimental cycle; and (3) breaking the cycle - validating patient-doctor relationships underpinned by clear communication can help break the negative cycle. Conclusions: Fibromyalgia patients experience uncertainty and chaos that can clash with the attitudes of GPs and the help they can feasibly provide. Difficult consultations in which neither the GP nor patient are satisfied can easily occur. Promoting supportive, reciprocal and open patient-doctor relationships is essential. Future research is required to further explore GP attitudes and to develop an intervention that could improve consultations, patient outcomes and GP satisfaction.

Type: Article
Title: Patient and primary care practitioners' perspectives on consultations for fibromyalgia: a qualitative evidence synthesis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1463423623000506
Publisher version: http://dx.doi.org/10.1017/s1463423623000506
Language: English
Additional information: © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativeco mmons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Keywords: Science & Technology, Life Sciences & Biomedicine, Primary Health Care, General & Internal Medicine, fibromyalgia, GP perspectives, patient perspectives, primary care consultations, qualitative evidence synthesis, OF-RHEUMATOLOGY 1990, DIAGNOSIS, EXPERIENCE, IMPACT, PAIN, CLASSIFICATION, MANAGEMENT, SOCIOLOGY, CRITERIA, ILLNESS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10193430
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