Objective: To describe general practitioners' (GPs') evaluation of and management strategies in relation to patients who seek medical advice because of multiple chemical sensitivity (MCS).
p>Design: A nationwide cross-sectional postal questionnaire survey. The survey included a sample of 1,000 Danish GPs randomly drawn from the membership list of GPs in the Danish Medical Association.
Results: Completed questionnaires were obtained from 691 GPs (69%).
Within the last 12 months:
• 62.4% (n=431) of the GPs had been consulted by at least one patient with MCS. Of these, 55.2% of the GPs evaluated the patients' complaints as chronic and 46.2% stated that they were rarely able to meet the patients' expectations for healthcare.
• The majority, 73.5%, had referred patients to other medical specialties.
The cause of MCS was perceived
• As multi-factorial by 64.3% of the GPs,
• As somatic/biologic by 27.6%,
• And as psychological by 7.2%.
Partial or complete avoidance of chemical exposures was recommended by 86.3%.
Clinical guidelines, diagnostic tools, or more insight in the pathophysiology were requested by 84.5% of the GPs.
• Despite the lack of formal diagnostic labeling, the patient with MCS is well known by GPs.
• The majority of the GPs believed that MCS primarily has a multi-factorial explanation.
• However, perceptions of the course of the condition and management strategies differed,
• And many GPs found it difficult to meet the patients' expectations for healthcare.
• The majority of the GPs requested more knowledge and clinical guidelines for the management of this group of patients.
Source: Scandinavian Journal of Primary Health Care, May 18, 2009;1-5. PMID: 19452353, by Skovbjerg S, Duus Johansen J, Rasmussen A, Thorsen H, Elberling J. Department of Dermatology, the Danish Research Centre for Chemical Sensitivities, Gentofte Hospital, University of Copenhagen.