A Multiple Streams Approach to Understanding the Issues and Challenges of Lyme Disease Management in Canada's Maritime Provinces

Abstract

This study examines potential challenges facing Lyme disease patients in Canada's Maritime provinces-New Brunswick, Nova Scotia, Prince Edward Island-and considers how issues could be addressed. Reviews of both the academic and grey literature are complemented by surveys targeting both medical professionals and decision makers in government. Combined, the literature reviews and surveys demonstrate that there is considerable debate surrounding the effectiveness of testing, treatment options, and the existence of chronic Lyme disease. As the focus on the Maritimes demonstrates, these debates often pit the medical community against patients and patient advocates and, thus far, governments have been unable to produce policy that entirely pleases either side. Moving forward, this study recommends the creation of a discussion forum via a federal Commission of inquiry to review best practise guidelines for Lyme disease. The key is to foster an unbiased probe of central issues surrounding treatment and diagnosis without alienating stakeholders. This course of action will not necessarily solve the issue of Lyme disease, but would foster a greater understanding through dialogue that includes and validates the experiences of stakeholders, which is something that is currently missing.

Keywords: Canada; Lyme disease; New Brunswick; Nova Scotia; Prince Edward Island; health policy; multiple streams; policy change; politics; ticks.

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Responses from family physicians, political leaders and government health officials to the survey question: In your opinion how prevalent is Lyme disease in the Maritimes?

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Responses from family physicians, political leaders and government health officials to the survey question exploring how often Lyme disease is mentioned in their day-to-day activities.

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Responses from family physicians, political leaders and government health officials to the frequency with which Lyme disease is discussed at length in their day-to-day work.

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Responses from family physicians identifying the percentage of patients that have requested testing or treatment been diagnosed with Lyme disease.

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Responses from family physicians, political leaders and government health officials assessing their knowledge level of ticks and Lyme disease.

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Responses from family physicians, political leaders and government health officials identifying their sources of information about ticks and Lyme disease.

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Responses from family physicians assessing how educated they felt their patients were about Lyme disease.

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Responses from family physicians, political leaders and government health officials for what politicians could do to improve how Lyme disease is addressed.

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Responses from family physicians, political leaders and government health officials assessing their satisfaction levels with the current available testing for Lyme disease.