How bad can it get ? Press coverage of the PACE Trial

Stonebird :

How bad can it get ??
Some initial Press Coverage of the PACE Trial


SKY News :

Study: 'Talking And Exercise Could Cure ME'

Co-author of the PACE study Professor Michael Sharpe said the results should end the controversy over the treatments - some patient groups insist that exercise does more harm than good.

He told Sky News: "Our hope is the evidence from this trial - which is the largest trial done in this condition - gives some solid evidence about what treatments help and importantly, that those treatments are safe.

"People have quite rightly been unclear what treatments help and have been worried whether they are safe.

"This trial should actually answer those concerns."



The Guardian

Study finds therapy and exercise best for ME



The biggest-ever study of treatments for ME, also known as chronic fatigue syndrome, has found that more people recover if they are helped to try to do more than they think they can – rather than adapting to a life of limited activity.

Although the numbers who recovered were small, Trudie Chalder, professor of cognitive behavioural psychotherapy at King's College, London, said that "twice as many people on graded exercise therapy and cognitive behaviour therapy got back to normal" compared with those in the other two treatment groups. Those on CBT and GET generally had less fatigue and were more physically active than the other patients at the end of the year.

Another author, Professor Peter White from Barts and the London school of medicine and dentistry, said: "While there is still room for improvement, this is a real step forward in informing patients with CFS/ME which treatments can help to improve their health and ability to lead a more normal life."


The Association of Young People with ME welcomed the findings and said it hoped it would begin to lay to rest fears about graded exercise therapy and CBT being harmful. It called for the study to be replicated in children. Mary-Jane Willows, AYME's chief executive, said: "These treatments should be made available to all patients by those who are trained and experienced in dealing with CFS/ME." She added that there was "an urgent need" to find a way to include house-bound patients in a trial. Participants in the study had to be able to get to hospital.


The Guardian



(CNN)

Study supports use of 2 controversial treatments for chronic fatigue



British researchers reported Friday that two controversial treatments for chronic fatigue syndrome appear to be more effective than a third, more commonly accepted treatment, and none of them appears to be linked to major safety problems.

The study was carried out because previous trials supporting cognitive behavior therapy and graded exercise therapy were small and controversial: Two British patients' organizations had surveyed their members and concluded the interventions were not only ineffective, but were harmful, said Dr. Michael Sharpe, professor of psychological medicine at the University of Edinburgh and one of the study's authors.

As an alternative, he told reporters in a news conference posted on the internet, the patient groups were expressing a preference for CFS patients to see specialists and undergo another intervention, called adaptive pacing therapy.

The non-rehabilitative pacing treatment helps patients live within the limits imposed by the illness rather than attempting to break through those limits.
It considers CFS to be an organic disease process that cannot be reversed by changing behavior and that leaves patients with a finite amount of energy.

Advocates of the treatment urge patients to pace themselves to avoid fatigue. A therapist advises patients on how to prioritize what they do, but urges them not to try to over do it.

The other two therapies push patients to try to overcome the limits of the illness: cognitive behavior therapy considers CFS to be reversible and recommends changes in behavior and cognition to gradually increase physical and mental activity. Advocates of graded exercise therapy seek to help patients gradually increase their energy level by challenging themselves to boost their exercise and other activity.

But the patient groups' anecdotal conclusions that cognitive behavior therapy and graded exercise therapy were detrimental did not hold up when subjected to the scrutiny of the rigorously designed study, which was carried out at six centers.


New York Times

Psychotherapy Eases Chronic Fatigue, Study Finds


The new study, conducted at clinics in Britain and financed by that country’s government, is expected to lend ammunition to those who think the disease is primarily psychological or related to stress.

The authors note that the goal of cognitive behavioral therapy, the type of psychotherapy tested in the study, is to change the psychological factors “assumed to be responsible for perpetuation of the participant’s symptoms and disability.”

The Press Association
Trial offers hope for ME sufferers

ME sufferers have been offered new hope following a landmark study which suggests the condition can be reversed with counselling and exercise.

Researchers have now identified two forms of treatment for chronic fatigue syndrome (CFS), both of which could help thousands of patients.

The ground-breaking study is the most comprehensive to date and challenges the widely accepted belief that the illness cannot be cured.

Scientists, who spent eight years on the research, believe it could herald a new dawn for the treatment of ME. They hope their findings will dispel the notion that nothing can be done for those living with the condition in the UK - a figure which currently stands at around a quarter of a million.

The Canadian Press
Behaviour and exercise therapy best for treating chronic fatigue syndrome: study



LONDON — The biggest ever study of chronic fatigue syndrome treatments has challenged the strategy championed by patient groups — taking it easy is not the best treatment, exercise and behaviour therapy are.

For years, patient groups warned such treatments could be dangerous, instead promoting a strategy known as adaptive pacing — which advises patients to adjust to their illness by simply doing less. But the study found that approach didn't help.

The research, published Friday in the medical journal, Lancet, concluded that behaviour and exercise seemed to moderately reduce fatigue and improve activity levels, while pacing and medical care wasn't much help.
The findings also suggests the crippling condition can sometimes be reversed.

"I hope more people will be convinced you can treat chronic fatigue syndrome and that this isn't necessarily something people will have forever," said Hans Knoop, a clinical psychologist at the Expert Centre for Chronic Fatigue in Nijmegen, the Netherlands, who co-authored an editorial on the research, which was funded by the U.K. Medical Research Council and others.


The Daily Telegraph

Exercise and therapy can help ME sufferers, study claims


The biggest study yet into possible ways to reduce the symptoms of Chronic Fatigue Syndrome - the little-understood condition that affects 250,000 people in Britain - claims to have identified the most effective combination of procedures and shown it is safe.

It says that Cognitive Behaviour Therapy (CBT), in which patients discuss their fear and avoidance of physical activity, combined with Graded Exercise Therapy, which helps sufferers gradually increase the amount of activity such as walking they can manage, is more effective and less harmful than previously thought.




The Independent

Got ME? Just get out and exercise, say scientists


Now researchers from London and Edinburgh who monitored 640 severely affected adults for a year have concluded that cognitive behaviour therapy (CBT), in which patients are helped to think about and test how they can do more, and graded exercise therapy (GET), in which they are helped gradually to overcome the limits imposed by the illness, are the most effective treatments. In contrast, helping sufferers live within their limits, called Adaptive Pacing Therapy (APT), was much less helpful.

Overall, 60 per cent of patients who received CBT or GET made progress and 30 per cent recovered sufficiently to resume normal lives. Among those who received APT, half as many (15 per cent) resumed normal lives. Fewer than one in ten patients left untreated recover, the researchers said.
Michael Sharpe, professor of psychological medicine at the University of Edinburgh, and co-author of the report, said: "This is a useful effect for a substantial proportion of those affected, but it is not a solution to the illness."
The findings, published in The Lancet, were hailed by experts in chronic fatigue as "very significant." Derrick Wade, professor of neurological enablement at the Oxford Centre for Enablement said: "This means we can allocate resources to treatments that will benefit patients and stop allocating resources to treatments that will not."

Nursing Times

Michael Sharpe, professor of psychological medicine at the University of Edinburgh and co-author of the report, said scientists had achieved a significant “milestone” by proving exercise therapy and CBT were both effective and safe.


BBC

Brain and body training treats ME


Chronic Fatigue Syndrome, also known as ME, should be treated with a form of behavioural therapy or exercise, say British scientists.

Writing in The Lancet, they argue that the approach preferred by some charities, managing energy levels, is less successful.

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