**5. Conclusions**

A group of academic and clinical experts on ME/CFS, from nineteen European countries, were strongly of the opinion that lack of knowledge and understanding of the illness

among primary care physicians, including disbelief in the very existence of the condition as a genuine clinical entity, was very widespread. As a result, they believed a high proportion had gone undiagnosed. There were seen to be inadequacies in both undergraduate and postgraduate teaching about the illness, and a lack of sources of advice and information for primary care. To address this, ME/CFS specialist centres for referral, support, and advice were needed, but in a majority of countries these either did not exist, or where present, existed only in certain restricted geographical locations. Further research is needed to survey GPs' attitudes in participating countries, and to develop programmes to inform and support healthcare professionals in the primary care sector.

**Supplementary Materials:** The following are available online at https://www.mdpi.com/article/10 .3390/medicina57030208/s1, Questionnaire: Survey of Diagnosis and Management of ME/CFS in Primary Care in Europe.

**Author Contributions:** Conceptualisation, all authors; methodology, D.F.H.P. and J.C.; validation, all authors.; formal analysis, J.C. and D.F.H.P.; investigation, D.F.H.P. and J.C.; writing—original draft preparation, D.F.H.P. and J.C.; writing—review and editing, J.C., D.F.H.P., J.-D.d.K., U.B., D.A., L.G., E.B., D.A.H., D.T., X.W.-S., and R.M.H.; project administration, D.F.H.P. All authors have read and agreed to the published version of the manuscript.

**Funding:** This article/publication is based upon work from COST Action "European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome", EUROMENE, supported by COST (European Cooperation in Science and Technology). COST (European Cooperation in Science and Technology) is a funding agency for research and innovation networks. Its actions help connect research initiatives across Europe and enable scientists to grow their ideas by sharing them with their peers. This boosts their research, career and innovation. This research received no external funding. EUROMENE receives funding for networking activities from the COST programme (COST Action 15111), via the COT Association. www.cost.eu. Accessed 25 February 2021.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** De-identified responses to the survey questions are available on request from the corresponding author.

**Conflicts of Interest:** The authors declare no conflict of interest.
