General practitioners' perspectives on patients presenting with endometriosis symptoms - an interview study.

Background: Endometriosis affects about one in ten women, yet diagnosis often takes eight to twelve years after onset of symptoms. In the Faroe Islands, GPs play a key role in recognizing symptoms, managing care and coordinating referrals to specialists. Therefore, GPs' perspectives on how challenges arise or how they could be improved are crucial to developing effective interventions for change.

Aim: To investigate how GPs in the Faroe Islands experience encounters with patients presenting with endometriosis symptoms.

Design & setting: Qualitative interview study with six GPs from various practice across the Faroe Islands.

Method: This study conducted semi-structured individual interviews and analysed participants' responses using systematic text condensation inspired by Malterud's thematic analysis to explore GPs' perspectives on their interactions with patients presenting with endometriosis symptoms.

Results: Within the constraints of the Faroese healthcare system, many GPs reported difficulties collaborating with gynaecologists on treatment protocols. Limited referral pathways often led to challenges, particularly when referrals were declined or when patients were returned to general practice without clear diagnosis or management plan. GPs expressed frustration with the limited treatment options available in primary care and a sense of being professionally constrained. They emphasized the need for specialist involvement and highlighted the importance of building long-term relationships with patients offering holistic care, managing expectations early, and maintaining continuity of care.

Conclusion: This study highlights the difficulties when GPs managing and referring patients with suspected endometriosis. Enhancing collaboration with specialists and improving referral protocols are crucial for optimising patients' care and outcomes.