Effectiveness of a group-based self-management program for people with CFS: A r

[Kati]

Effectiveness of a group-based self-management program for people with chronic fatigue syndrome: A randomized controlled trial.

http://www.ncbi.nlm.nih.gov/pubmed/26672998

Clin Rehabil. 2015 Dec 16. pii: 0269215515621362. [Epub ahead of print]
Effectiveness of a group-based self-management program for people with chronic fatigue syndrome: A randomized controlled trial.
Pinxsterhuis I1, Sandvik L2, Strand EB3, Bautz-Holter E4, Sveen U5.
Author information

Abstract
OBJECTIVE:
To evaluate the effectiveness of a group-based self-management program for people with chronic fatigue syndrome.

DESIGN:
A randomized controlled trial.

SETTING:
Four mid-sized towns in southern Norway and two suburbs of Oslo.

SUBJECTS:
A total of 137 adults with chronic fatigue syndrome.

INTERVENTION:
A self-management program including eight biweekly meetings of 2.5 hours duration. The control group received usual care.

MAIN MEASURES:
Primary outcome measure: Medical Outcomes Study-Short Form-36 physical functioning subscale.

SECONDARY OUTCOME MEASURES:
Fatigue severity scale, self-efficacy scale, physical and mental component summary of the Short Form-36, and the illness cognition questionnaire (acceptance subscale). Assessments were performed at baseline, and at six-month and one-year follow-ups.

RESULTS:
At the six-month follow-up, a significant difference between the two groups was found concerning fatigue severity (p = 0.039) in favor of the control group, and concerning self-efficacy in favor of the intervention group (p = 0.039). These significant differences were not sustained at the one-year follow-up. No significant differences were found between the groups concerning physical functioning, acceptance, and health status at any of the measure points. The drop-out rate was 13.9% and the median number of sessions attended was seven (out of eight).

CONCLUSIONS:
The evaluated self-management program did not have any sustained effect, as compared with receiving usual care.

© The Author(s) 2015.

 

[Kati]

Well here is a honest randomized clinical trial from Norway, self management group sessions vs usual care: it does not make a difference.

 

[A.B.]

What is a group based self management program?

Judging from the results it looks like something that would motivate patients to do more.

 

[Kati]

What is a group based self management program?

Judging from the results it looks like something that would motivate patients to do more.

Group session to learn more about self-management. sleep, exercise, diet, living with ME/CFS.
This is my interpretation. i did not see the full paper.

 

[daisybell]

So while attending the group, the participants felt slightly more in control, but got tired due to the effort of attending, and the effects wore off when they stopped going????

 

[sarah darwins]

Anyone know what "usual care" is?

 

[duncan]

A glass of bourbon and an Ambien?

 

[Kati]

Anyone know what "usual care" is?

Usual care is when you go to your dr for a regular visit, and you update on your symptoms and they try to help out.

 

[jimells]

Anyone know what "usual care" is?

From what I can make out from these kind of studies, "usual care" means "any treatment (or none) other than the treatment being studied".

 

[jimells]

A glass of bourbon and an Ambien?

I think for most patients that would be "cruel and unusual punishment".

 

[sarah darwins]

I asked because I've seen "usual care" bandied about in these studies before, but no one seems to specify what it is. Which, to a non-scientist, sounds very unscientific.

 

[jimells]

I asked because I've seen "usual care" bandied about in these studies before, but no one seems to specify what it is. Which, to a non-scientist, sounds very unscientific.

As I understand it (as a fellow non-scientist), the "ideal" comparison group for these kind of trials would be "no treatment of any kind", but that would be unethical. That means "usual care" is an ethical work-around that ends up being a poorly-characterized group, in the sense that probably no one really knows just what treatment they received.

"Usual care" must be a statistician's nightmare - I wonder how they deal with it...

 

[sarah darwins]

As I understand it (as a fellow non-scientist), the "ideal" comparison group for these kind of trials would be "no treatment of any kind", but that would be unethical. That means "usual care" is an ethical work-around that ends up being a poorly-characterized group, in the sense that probably no one really knows just what treatment they received.

"Usual care" must be a statistician's nightmare - I wonder how they deal with it...

That makes sense re the ethical bit. I just would have thought that, given the vast differences people here report in terms of what they get from primary care, you would need to select people for both the study and control groups who were getting much the same "usual care" for the results to be at all meaningful. Maybe they did that, though the abstract makes no mention of it.

Edit: like this - "To test this hypothesis, we collected symptom reports and blood and stool samples from ten clinically characterized ME/CFS patients and ten matched healthy controls ..." - from a newly published biomedical study reported here

That "matched" seems kind of important.

 

[Tom Kindlon]

Group interventions have a poor record for ME/CFS. See my earlier published letter:
http://www.iacfsme.org/Portals/0/pdf/Kindlon Letter - vol17 n3.pdf