What patients tell us: Assessing feedback and perspectives of patients with post-treatment Lyme disease symptoms.

Main Article Content

Meghan McCarthy, ScB Sara Vargas, PhD Jennifer Adelson-Mitty, MD Jennie Johnson, MD Timothy P. Flanigan, MD

Abstract

While most patients with Lyme disease fully recover within 6 months, a minority of patients develop significant and persistent symptoms after appropriate antibiotic treatment. With no clear pathophysiology or treatment, post-treatment Lyme disease (PTLDS) (also sometimes referred to as chronic Lyme) is a highly contested condition within the medical community. After conducting a phone survey of 25 patients who had visited an outpatient, academic center for Lyme and other tick-borne diseases, we collected and summarized patients’ perspectives and feedback of the care they received for ongoing Lyme-related symptoms. Findings from this phone survey demonstrated an extremely varied history with regards to experiences with diagnosis, treatment, and management of long-term symptoms. Key themes include a wide-ranging but life-altering self-reported symptomatology, pervasive doubts/frustrations in the medical system regarding treatment of PTLDS symptoms, and how often patients tried unconventional and nontraditional treatment methods. Importantly, patients were unified in their appreciation for an approachable and validating healthcare team even if they did not find complete resolution in their symptoms.

Keywords: patients with post-treatment Lyme disease symptoms, post-treatment Lyme disease symptoms, PTLDS, Assessing feedback and perspectives of patients with PTLDS

Article Details

How to Cite
MCCARTHY, Meghan et al. What patients tell us: Assessing feedback and perspectives of patients with post-treatment Lyme disease symptoms.. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5196>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v12i3.5196.
Section
Research Articles

References

1. Aucott JN. Posttreatment Lyme Disease Syndrome. Infectious Disease Clinics of North America. 2015;29(2):309-323. doi:10.1016/j.i dc.2015.02.012

2. Lantos P. Chronic Lyme disease: the controversies and the science. research-article. Expert Review of Anti-infective Therapy. 10 Jan 2014 2014;doi:10.1586/eri.11.63

3. Lantos PM, Charini WA, Medoff G, et al. Final report of the lyme disease review panel of the infectious diseases society of America. Clin Infect Dis. 7 2010;51:1-5. doi:10.1086/ 654809

4. Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clinical Infectious Diseases. 2020;72(1):e1-e48. doi:10 .1093/cid/ciaa1215

5. Berende A, Ter Hofstede HJM, Vos FJ, et al. Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis. Neurology. 3 2019;92(13):E1447-E1455. doi: 10.1212/WNL.0000000000007186

6. Krupp L. Study and treatment of post Lyme disease (STOP-LD): A randomized double masked clinical trial. Neurology. 2003;60(12):1923 - EOA. doi:10.1212/01.WN L.0000071227.23769.9E

7. Aucott JN, Rebman AW, Crowder LA, Kortte KB, . Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: Is there something here? Quality of Life Research. 2 2013;22:75-84. doi:10.1007/s11136-012-0126-6

8. Vargas SE, McCarthy ML, Boudreau M, Canfield D, Reece R, Flanigan T. Characterizing the Symptoms of Patients with Persistent Post Treatment Lyme Symptoms: A Survey of Patients at a Lyme Disease Clinic in Rhode Island. R I Med J (2013). 2021;104(3):53-57.

9. Ali A, Vitulano L, Lee R, Weiss TR, Colson ER, . Experiences of patients identifying with chronic Lyme disease in the healthcare system: A qualitative study. BMC Family Practice. 5 2014;15:79. doi:10.1186/1471-2296-15-79

10. Lantos PM, Shapiro ED, Auwaerter PG, et al. Unorthodox Alternative Therapies Marketed to Treat Lyme Disease | Clinical Infectious Diseases | Oxford Academic. Clin Infect Dis. 2015;60(12):1776-1782.

11. Naidu A, . James TL, Calderon ED, Cook DF. Exploring patient perceptions of healthcare service quality through analysis of unstructured feedback. Expert Systems with Applications. 2017 Apr 1;71:479-92. 6 2009;2 2:366-381. doi:10.1108/09526860910964834

12. Luxford K, Safran DG, Delbanco T. Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience. International Journal for Quality in Health Care. 2011;23(5):510-515. doi:10.1093/intqhc/mzr024

13. McCarthy ML, Reece R, Vargas SE, Johnson J, Adelson-Mitty J, Flanigan T. Lessons Learned from a Rhode Island Academic Out-Patient Lyme and Tick-Borne Disease Clinic. R I Med J (2013). 2020;103(10):51-55.

14. Vargas SE, Guillen M, McCarthy M, Canfield D, Flanigan T. Characterizing post-treatment Lyme disease syndrome: A mixed methods study of patients at a Lyme disease clinic in Rhode Island. R I Med J (2013). 2021;

15. Vargas S, Boudreau, M, McCarthy, M, Canfield, D, Reece, RM, & Flanigan, T., . Chronic Lyme patients report levels of fatigue similar to patients with other chronic illness: A symptom survey study. 2019;

16. Epstein RM, Street RL. The values and value of patient-centered care. 3 2011;9:100-103. doi:10.1370/afm.1239

17. Johnson L, Wilcox S, Mankoff J, Stricker RB. Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey. PeerJ. 2014;2:e322. doi:10.7717/peerj.322

18. Arnold LM, Crofford LJ, Mease PJ, et al. Patient perspectives on the impact of fibromyalgia. Patient Education and Counseling. 10 2008;73:114-120. doi:10.1016/j.pec.2008. 06.005

19. Cunningham MM, Jillings C, . Individuals' Descriptions of Living With Fibromyalgia. Clinical nursing research. 2006;15(4):258-273. doi:10.1177/1054773806291853

20. Lobo CP, , Pfalzgraf AR, et al. Impact of invalidation and trust in physicians on health outcomes in fibromyalgia patients. 2014;16doi:10.4088/PCC.14m01664

21. E VH. The doctor-patient relationship in chronic fatigue syndrome: survey of patient perspectives. Quality in Primary Care. 2009;17(4):263-270.

22. Merkes M. Mindfulness-based stress reduction for people with chronic diseases. Australian journal of primary health. 2010;16(3):200-210.

23. Friedberg F, Williams DA, Collinge W, . Lifestyle-oriented non-pharmacological treatments for fibromyalgia: A clinical overview and applications with home-based technologies. 2012;5:425-435. doi:10.2147/ JPR.S35199

24. Pavli A, Theodoridou M, Maltezou HC. Post-COVID syndrome: Incidence, clinical spectrum, and challenges for primary healthcare professionals. Archives of medical research. 2021;52(6):575-581.