CHRONIC DEBILITATING FATIGUE IN IRISH GENERAL-PRACTICE - A SURVEY OF GENERAL-PRACTITIONERS EXPERIENCE

Background. Doctors are called upon to treat chronic debilitating fati gue without the help of a protocol of care. Aims. To estimate the inci dence of chronic debilitating fatigue in Irish general practice, to ob tain information on management strategy and outcome, to explore the at titudes of practitioners (GPs) towards the concept of a chronic fatigu e syndrome (CFS), and to recruit practitioners to a prospective study of chronic fatigue in primary care. Method A total of 200 names were s elected from the database of the Irish College of General Practitioner s (ICGP); 164 of these were eligible for the study. Results. Altogethe r, 178 questionnaires were returned (72%). Ninety-two (78%) responders identified cases of chronic fatigue, giving an estimated 2.1 cases pe r practice and an incidence of 1 per 1000 population. All social class es were represented, with a male to female ratio of 1:2. Eleven dispar ate approaches to treatment were advocated. Many (38%) were dissatisfi ed with the quality of care delivered, and 45% seldom or hardly ever r eferred cases for specialist opinion. The majority (58%) accepted CFS as a distinct entity, 34% were undecided, and 8% rejected it Forty-two (35%) GPs volunteered for a prospective study. Conclusion. Chronic fa tigue is found in Irish general practice among patients of both sexes and all social classes. Doctors differ considerably in their managemen t of patients and are dissatisfied with the quality of care they deliv er. Many cases are not referred for specialist opinion. A prospective database is required to accurately assess the scale of this public hea lth problem and to develop a protocol of care.