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General practitioners’ experiences with provision of healthcare to patients with self-reported multiple chemical sensitivity – Source: Scandinavian Journal of Primary Health Care, May 18, 2009

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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.

Setting: Denmark.

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.

Conclusion:

• 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.

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