(Originally posted on Co-Cure)
- yet Peter White and the other PACE Trial investigators are not planning to publish the recovery outcome measure (a secondary outcome measure) from the £5m PACE Trial, nor will they give it in response to a Freedom of Information Act request.
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The definition was broad: 42% in the SMC (control-type group) also satisfied the post-hoc criteria for a clinically useful improvement.
The more strict primary outcome "overall improvers" has never been published and they do not intend to publish it or release it in response to a Freedom of Information request]
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http://bit.ly/RieusW i.e.
http://www.nhsconfed.org/Publications/Documents/Investing in emotional and psychological wellbeing for patients with long-tern conditions 18 April final for website.pdf
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Taken from:
http://www.nhsconfed.org/Publicatio...ndPsychologicalWellbeingLongTermPatients.aspx
"In the Barts service, an outcome of improvement in 75 per cent of patients is expected, with a third of those (25 per cent) expected to recover if given sufficient treatment."
- yet Peter White and the other PACE Trial investigators are not planning to publish the recovery outcome measure (a secondary outcome measure) from the £5m PACE Trial, nor will they give it in response to a Freedom of Information Act request.
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"The PACE trial showed outcomes of approximately 60 per cent of patients making a clinically useful improvement* in both symptoms and disability with either CBT or graded exercise therapy."
The definition was broad: 42% in the SMC (control-type group) also satisfied the post-hoc criteria for a clinically useful improvement.
The more strict primary outcome "overall improvers" has never been published and they do not intend to publish it or release it in response to a Freedom of Information request]
=====================
http://bit.ly/RieusW i.e.
http://www.nhsconfed.org/Publications/Documents/Investing in emotional and psychological wellbeing for patients with long-tern conditions 18 April final for website.pdf
"Chronic fatigue syndrome service: St Bartholomew's (Barts) Hospital, London
The chronic fatigue syndrome service at St Bartholomew's (Barts) Hospital, jointly provided by Barts & The London NHS Trust and East London NHS Foundation Trust, and managed by the latter, is unique in that it is clinically led by a consultant physician (infectious
diseases) and a consultant liaison psychiatrist (see http://bartscfs.eastlondon.nhs.uk). This allows it to properly assess patients, referred mainly by GPs, since three service audits from different NHS services have shown that around
40 per cent of such patients are found not to have chronic fatigue syndrome, with half of these having an alternative medical diagnosis (for example, sleep apnoea) and the other half having an alternative psychiatric diagnosis (for example, depressive illness). Assessment is therefore crucial to a good outcome.
Once a diagnosis of chronic fatigue syndrome is made, patients are referred to one of the multidisciplinary team for further assessment, with a view to rehabilitative therapy. The NICE
guidelines162 suggest that the two therapies with the best research evidence of effectiveness are individually delivered cognitive behaviour therapy (CBT) and graded exercise therapy.
The recently published PACE trial (see www.pacetrial.org) showed that these therapies were both moderately effective and safe, when added to specialist medical care, and when individually delivered by appropriately qualified therapists who had received appropriate training and supervision. Receipt of specialist medical care alone and specialist medical care supplemented by pacing therapy (staying within limits imposed by the illness) were less effective at helping both symptoms and disability. The aims of therapy are to provide amelioration of maintaining factors that are keeping a patient unwell. These are known to be illness beliefs, inactivity (or extremes of activity) as well as deconditioning, sleep and mood problems.
The Barts service provides patient choice, in that both individually delivered CBT and graded exercise therapy are available, as well as individually delivered occupational therapy (providing graded activity therapy and occupational support). A recent audit of group-delivered rehabilitation therapy (combining all the above) showed high levels of patient satisfaction, but limited effectiveness.
This is now being reviewed. Complementary to this, all patients receive specialist medical care, which consists of generic advice about managing the illness as well as prescribed medicines to treat associated symptoms (such as insomnia) and co-morbid illnesses (such as depressive illness). An information session has recently been introduced for all newly diagnosed patients to educate about the illness and treatment options. The session is available to patients, their families and carers.
The PACE trial showed outcomes of approximately 60 per cent of patients making a clinically useful improvement* in both symptoms and disability with either CBT or graded exercise therapy. In clinical practice, slightly less impressive results would be expected, as demonstrated by the National Outcome Database of 26 NHS services (see www.bacme.info/document_uploads/ NOD/NODpres.pdf). These services are equally effective at reducing symptoms, but less effective at improving disability. In the Barts service, an outcome of improvement in 75 per cent of patients is expected, with a third of those (25 per cent) expected to recover if given sufficient treatment. A normal course of treatment is composed of 30 sessions, including medical care. In the PACE trial, participants received up to 15 sessions of therapy and about four medical consultations in a year.
For further details, contact:
Professor Peter White, Professor of Psychological Medicine, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry p.d.white@qmul.ac.uk"
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Taken from:
http://www.nhsconfed.org/Publicatio...ndPsychologicalWellbeingLongTermPatients.aspx
Investing in emotional and psychological wellbeing for patients with long-term conditions.
Date: 18/04/2012 (i.e. April 18th, 2012)
Stock Code: BOK60053
Format: Electronic
A guide to service design and productivity improvement for commissioners, clinicians and managers in primary care, secondary care and mental health.
For many patients, several physical illnesses will coexist at any one time, and for some a mental health disorder will also be present. In the face of such multi-morbidity and need, focus on the patient journey across the lifespan and across the care system will maximise effective service design and delivery.
The collation of evidence and emerging economic analysis, together with examples of service design and delivery in this guide, will assist commissioners, clinicians and managers in primary care, secondary care and mental health in designing services, improving productivity and learning across disease-specific groups.