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Apr 2024

FM, ME/CFS, POTS, and MCS

Introduction

Fibromyalgia (FM), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS),  Postural Orthostatic Tachycardia Syndrome (POTS), and Multiple Chemical Sensitivity (MCS) are chronic health conditions. Accurate diagnosis and targeted management can improve the quality of life of individuals living with FM, ME/CFS, and POTS. These tools are designed to support family physicians and primary care nurse practitioners in recognizing, assessing, diagnosing and managing FM, ME/CFS, and POTS in adult patients.

Additional resources


Information

About the tool

These tools are designed to guide discussions and decision-making between clinicians and their patients with FM, ME/CFS, and POTS. Each tool aims to support clinicians with:

  • Recognizing core symptoms and symptom constellations for each condition.
  • Prioritizing symptoms to carry out a comprehensive assessment.
  • Diagnosing each condition in a timely manner by recognizing key diagnostic features.
  • Developing an individualized and supportive management plan with the patient to improve their quality of life.


For MCS, the current state of the evidence base is described.

The FM, ME/CFS, and POTS tools were developed using the Centre for Effective Practice’s (CEP’s) integrated knowledge translation approach. Clinical leadership of the FM, ME/CFS, and POTS tools was provided by Dr. Farah Tabassum. Persons with lived experience, end users and clinical experts were also engaged to provide feedback.

These tools are among several clinical tools developed as part of the Knowledge Translation in Primary Care Initiative. Funded by the Ministry of Health, this initiative supports primary care providers with the development of a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative (KTinPC).

Clinical leads

  • Farah Tabassum

    MD CCFP FCFP

    Dr. Farah Tabassum is a consultant physician on staff at Women's College Hospital's Environmental Health Clinic (EHC) and is a part time Clinical Lecturer with the Department of Family and Community Medicine at the University of Toronto. 

    Prior to joining the EHC, she completed a PGY-3 Enhanced Skills Program in Clinical Environmental Health through the Department of Family and Community Medicine at the University of Toronto. Alongside this program, she completed Functional Medicine training through the Institute of Functional Medicine. Earlier in her career, she was on staff as a primary care provider for over 15 years at a Community Health Centre and previously had a GP psychotherapy practice.       

    In addition to her work at the EHC, she serves as a consultant physician with Ontario’s eConsult physicians group, on the topics of Post COVID Condition fatigue and for the Environmental Health group. She is a member of the Interdisciplinary Canadian Collaborative Myalgic Encephalomyelitis (ICanCME) research network, presently serving on their Executive Committee and on their Diagnosis, Clinical Assessment and Trial Development working group.       

    Dr. Tabassum provided clinical leadership for the development of the FM, ME/CFS and POTS tools.


    Clinical leads are offered compensation for their roles. 

Topic Expert Group

Fibromyalgia

  • Denise Magi, Lived Experience Advisor, President and Chair of CareNow Ontario
  • Sharron Ellis, Lived Experience Advisor
  • Kathleen Dennis, Lived Experience Advisor, RN (non-practicing)
  • Moira Sarah Selke MB BCh BAO, CCFP, Environmental Health Clinic, Women’s College Hospital

Myalgic encephalomyelitis/chronic fatigue syndrome

  • Denise Magi, Lived Experience Advisor, President and Chair of CareNow Ontario
  • Kathleen Dennis, Lived Experience Advisor, RN (non-practicing)
  • Moira Sarah Selke MB BCh BAO, CCFP, Environmental Health Clinic, Women’s College Hospital

Postural orthostatic tachycardia syndrome

  • Jennifer Hulme, Lived Experience Advisor, Physician, and Assistant Professor at the DFCM
  • Kathleen Dennis, Lived Experience Advisor, RN (non-practicing)
  • Moira Sarah Selke MB BCh BAO, CCFP, Environmental Health Clinic, Women’s College Hospital 
    ​​​​​​​

Topic Expert Group members were offered an honorarium for their participation. Thank you to all our members for their work!

Expert Reviewers

Trudy Flynn, Chair of Fibromyalgia Association Canada

Dr. Andrea Furlan MD PhD, Toronto Rehabilitation Institute 

Dr. Paula Harvey BMBS, PhD, FRACP

Dr. Satish R Raj MD MSCI FRCPC

Janice Sumpton








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