How is paediatric chronic fatigue syndrome/myalgic encephalomyelitis diagnosed and managed by paediatricians? An Australian Paediatric Research Network Study
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Sarah Knight1, Adrienne Harvey, Susan Towns
1Clinical Sciences, Murdoch Childrens Research Institute, Perth, Western Australia, Australia; Victorian Paediatric Rehabilitation Service, The University of Melbourne, Perth, Western Australia, Australia; Department of Paediatrics, The University of Melbourne, Perth, Western Australia, Australia; The Melbourne School of Psychological Sciences, The University of Melbourne, Perth, Western Australia, Australia.
Insights
Australian paediatricians show wide variation in diagnosing and managing paediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This highlights a need for improved guidelines and education for better treatment outcomes.
Area of Science:
- Paediatric Medicine
- Neurology
- Rheumatology
Background:
- Paediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) diagnosis and management present significant challenges.
- Understanding current national practices is crucial for identifying areas for research and educational improvement in paediatric CFS/ME treatment.
Purpose of the Study:
- To investigate the current diagnostic criteria, medical investigations, and management strategies employed by Australian paediatricians for CFS/ME.
Main Methods:
- An online survey was distributed to members of the Australian Paediatric Research Network.
- Data collected focused on diagnostic approaches and treatment modalities for paediatric CFS/ME.
Main Results:
- 39% of responding paediatricians diagnose and manage paediatric CFS/ME, with significant variability in diagnostic investigations.
- Commonly co-occurring conditions include somatisation disorders, anxiety, depression, and fibromyalgia.
- Management strategies varied, but most practitioners involved school teachers, physiotherapists, and psychologists.
Conclusions:
- Paediatrician practices for CFS/ME in Australia are highly diverse, indicating a lack of specific paediatric guidelines and evidence-based best practices.
- There is a clear need for enhanced guidance and educational resources for diagnosing and managing paediatric CFS/ME in Australia.
Aim:
The diagnosis and management of paediatric chronic fatigue syndrome/myalgic encepnalomyelitis (CFS/ME) represent ongoing challenges for paediatricians. A better understanding of current approaches at a national level is important in informing where research and education could improve treatment outcomes. We aimed to examine current diagnosis and management practices for CFS/ME by Australian paediatricians.
Method:
An online survey was sent to members of the Australian Paediatric Research Network. The primary outcomes of interest included diagnostic criteria used, medical investigations and management practices in paediatric CFS/ME.
Results:
One hundred seventy-eight (41%) of 430 eligible paediatricians responded, with 70 of the 178 (39%) reporting that they diagnose and manage CFS/ME as part of their practice. Medical investigations used for diagnosis were variable. Conditions that more than half of the paediatricians reported as commonly co-occurring (i.e. present in >50% of cases) included somatisation disorders, anxiety, depression and fibromyalgia. There was wide variation in behavioural and pharmacological management strategies but most paediatricians commonly engaged a school teacher, physiotherapist and/or psychologist as part of their management.
Conclusion:
The diagnostic and management practices of paediatricians for CFS/ME within Australia vary widely. This likely reflects a paucity of paediatric-specific guidelines, together with limited evidence to guide best practice and limited training in this area. There is a need for guidance and education for the diagnosis and management of paediatric CFS/ME in Australia.