How do I structure follow-up visits to track and promote progress

How do I Structure Follow-up visits to track and promote progress

Well-established and accepted protocols that provide
clear guidance as to what variables should be tracked
and what problems should be followed from visit to
visit are lacking for FM. However, there is much good
work that can be accomplished with patients with FM from visit to visit, beyond medication management
and consistent with the chronic care framework.

Key points for structuring follow-up visits and promoting progress1

  • Structure office visits to focus on desired functional outcomes and monitoring symptoms in key
    domains and the specific goals to which the patient has agreed
    • Eg, home, work, and recreation; walking 10 minutes a day
  • At each visit, ask patients how much physical activity they are doing and how much they are using
    self-management techniques to emphasize the importance of these aspects of care
  • Encourage patients to take ownership of FM management by giving simple "homework"
    • For instance, ask the patient to look up information on specific topics and report back. When you
      do so, note it in the chart, and ask about it at the next visit
  • As the patient's situation improves or changes, the patient's priorities and goals will change as well;
    goal setting and follow-up thus become a dynamic process
Reference:

1. McCarberg BH. Fibromyalgia management for the primary care provider. In: McCarberg BH, Clauw DJ, eds. Fibromyalgia. New
York, NY: Informa Healthcare; 2009:152-158.