Australian ME/CFS Best Practice Primary Care Service Models are based on data gathered from a series of research and service outcome projects, and the 2014 International ME/CFS General Practice Primer.
They provide care pathways / care plan protocols for Australian General Practice Clinics consistent with Medicare, team care and chronic disease management.
Care plans and care pathways are individually tailored for each patient and the stage of their condition. They involve a plan of action which is reviewed annually.
Management is patient-centred, multi-disciplinary and wellness focussed.
1. Australian ME/CFS Best Practice General Practice Care (2016) includes:
- An accurate diagnosis based on the International ME/CFS criteria (may take several visits)
- Best practice ME/CFS medical care tailored for each patient. They recommend early intervention and a targeted problem solving approach and tailored patient-centred care planning
- Layered Comprehensive Assessments to clinically group and guide treatment choices
- Health coaching to support shared care and case management
- Care planning (Medicare CDMP) that will outline your health care needs, services and treatments for the coming year, and lists of what you need to do
- Allied health professionals who understand the physical condition ME/CFS e.g. exercise therapist, dietitian, psychologist, physiotherapist
- Care and health outcomes are reviewed and adjusted regularly according to patient feedback and treatment outcomes towards optimal management.
2. The Australian ME/CFS Best Practice Care Pathways Service Models (2008) include:
- Comprehensive Assessments and an accurate diagnosis
- Care planning and referrals to allied health and community programs coordinated by a Medicare care plan
- Best practice ME/CFS medical care tailored for each patient. They recommend early intervention and a targeted problem solving approach and tailored patient-centred care planning.
- Allied health interventions are multi-disciplinary, tailored for each patient and introduced one at a time, on a start low / go slow basis.
- The Best Practice Australian ME/CFS Integrated Education Model contains 8 components or core steps consistent the Flinders Chronic Disease Management Program:
- Have knowledge of ME/CFS and management options
- Have a treatment and care plan to coordinate a healthcare team
- Actively share in decision making with the healthcare team
- Monitor and manage the signs and symptoms of ME/CFS
- Manage ME/CFS using a mixture of medical and lifestyles decisions (physical, mental, emotional and social life)
- Adopt a lifestyle that promotes health (sleep, stress, diet and movement)
- Extend the care plan to use education, community and other support services
- Regularly review the care in partnership with your case manager
Additional models are currently being evaluated in General Practice settings.