Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?
Abstract
:1. Introduction
Questions
- What is the effect of CBT and/or GET on work status in ME/CFS post-treatment?
- What percentage of patients return to full- or part-time work?
- Are both treatments safe?
2. Methods
Exclusion Criteria
3. Results
3.1. Selection of Articles
3.2. Drop-Outs
3.3. Work Status
4. Safety
5. Discussion
Strengths and Weaknesses of This Review
- inclusion of work outcome analysis in a very large number of patients (3721) before and after treatment with CBT and GET;
- inclusion of the evaluation reports of the official Belgian and English CFS clinics by advocates of CBT and GET with >1600 patients not specially selected for a clinical trial, so that it becomes clear what the effectiveness of both therapies in daily life is;
- inclusion of the research report of an English university (n = 2274) on the safety of both therapies in the context of the revision of the National ME/CFS guideline in England.
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
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Study | Intervention | N | Criteria | FU Length | Control Group | Work Outcome | Dropouts |
---|---|---|---|---|---|---|---|
Collin and Crawley [39] | CBT and GET evaluation in 11 English CFS clinics | 952 | NICE | 1 yr | Evaluation study | After therapy: 47.2% unchanged working status; 18.0% worked again or longer; 30.0% stopped working or worked less because of CFS | Response rate: 46.2% |
Huibers et al. [31] | CBT by general practitioners | 151 (fatigue; 43% CFS) | Fukuda | 12 mo | No treatment | After 4 mo 50% (CBT) and 61% (NT) and after 12 mo 59% (CBT) and 65% (NT) were back at work. | 33% CBT, 9.3% NT |
Koolhaas et al. [37] | Evaluation of CBT in The Netherlands | 100 | Fukuda | Evaluation study | Evaluation study | 41% were employed before and 31% after CBT; patients who worked, worked 5 h less after CBT | Response rate: 100% |
O’Dowd et al. [35] | GrCBT with graded activity | 153 | Fukuda | 12 mo | No treatment | The authors concluded that group CBT did not significantly improve employment status. | No cognitive test data: 28.9% CBT, 13.7% NT |
Prins et al. [36] | CBT vs. Guided Support | 278 | Oxford | 14 mo | No treatment | No statistically significant difference in the number of hours worked after 8 (p = 0.3362) and 14 mo (p = 0.1134) between CBT and NT | 40.9% CBT and 23.1% NT |
Ridsdale et al. [32] | CBT vs. counseling | 160 (fatigue; 28% CFS) | Fukuda | 6 mo | Counselling | Number of sick days decreased by 4.3% (counselling) vs. increased by 6.6% (CBT) | 36% counselling and 31% CBT |
Stevelink et al. [41] | CBT (285), GET (28), APT (2), CBT and GET (1) | 508 | Oxford | 285 days | Evaluation study | On average 16.5 treatment sessions. Fatigue and physical functioning scores did not improve; 9% returned to work, 6% stopped working, net improvement 3%, depression caseness improved by 2%; 23% (53/229) of patients who were classed as not working at baseline, were already well enough to work before they had received any treatment. | 38% |
Stordeur et al. [40] | CBT and GET evaluation in Belgian CFS clinics | 655 | Fukuda | Evaluation study | Evaluation study | Work status decreased from 18.3% to 14.9%; percentage of incapacitated persons increased from 54% to 57% | 28% |
Van Berkel et al. [38] | GET evaluation in sports medical department of Dutch hospital | 123 | Fukuda | 12 months | Evaluation study | Work status at 3 and 12 months did not change | 33% (6 months) and 72% (12 months) |
White et al. [33] | CBT vs. GET vs. APT | 641 | Oxford | 52 wks | SMC (no treatment) | Lost working years remained 84% (CBT); increased from 83% to 86% (GET). Unemployment rates increased from 10% to 13% (CBT) and from 14% to 20% (GET); disability benefits increased from 32% to 38% (CBT) and from 31% to 36% (GET); private disability benefits increased from 6% to 12% (CBT) and from 8% to 16% (GET) | 10.5% CBT, 6.3% GET. Missing step test data: 33.8% GET and 29.8% CBT |
Study | Adverse Outcomes Reported | Intervention | Adverse Events |
---|---|---|---|
Collin and Crawley [39] | Yes | CBT and GET | Overall change in health: 20.1% felt worse at 1-year and 30.6% at 5-year follow-up |
Huibers et al. [31] | Yes | CBT by GPs | None |
Koolhaas et al. [37] | Yes | CBT | 38% negatively affected by CBT |
O’Dowd et al. [35] | No | Group CBT with Graded Activity | Not reported |
Prins et al. [36] | No | CBT vs. guided support | Not reported |
Ridsdale et al. [32] | No | CBT vs. counseling | Not reported |
Stevelink et al. [41] | No | CBT vs. GET vs. APT vs. CBT and GET | Not reported |
Stordeur et al. [40] | No | CBT and GET | Not reported |
Van Berkel et al. [38] | Yes | GET | Increase in tiredness: 13.7% (3 months) and 11.5% (12 months) |
White et al. [33] | Yes | CBT vs. GET vs. APT | SAE: 1% APT, 2% CBT, 1% GET and 1% SMC |
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Vink, M.; Vink-Niese, F. Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID? Healthcare 2022, 10, 392. https://doi.org/10.3390/healthcare10020392
Vink M, Vink-Niese F. Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID? Healthcare. 2022; 10(2):392. https://doi.org/10.3390/healthcare10020392
Chicago/Turabian StyleVink, Mark, and Friso Vink-Niese. 2022. "Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?" Healthcare 10, no. 2: 392. https://doi.org/10.3390/healthcare10020392
APA StyleVink, M., & Vink-Niese, F. (2022). Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID? Healthcare, 10(2), 392. https://doi.org/10.3390/healthcare10020392