* I gave each sentence its own paragraph.Effectiveness of internet-based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): a randomised controlled trial
The Lancet, Early Online Publication, 1 March 2012 doi:10.1016/S0140-6736(12)60025-7
Dr Sanne L Nijhof MD a , Prof Gijs Bleijenberg PhD c, Cuno SPM Uiterwaal PhD b, Prof Jan LL Kimpen PhD a, Elise M van de Putte PhD a
Summary*
Background
Chronic fatigue syndrome is characterised by persistent fatigue and severe disability.
Cognitive behavioural therapy seems to be a promising treatment, but its availability is restricted.
We developed Fatigue In Teenagers on the interNET (FITNET), the first dedicated internet-based therapeutic program for adolescents with this disorder, and compared its effectiveness with that of usual care.
Methods
Adolescents aged 1218 years with chronic fatigue syndrome were assigned to FITNET or usual care in a 1:1 ratio at one tertiary treatment centre in the Netherlands by use of a computer-generated blocked randomisation allocation schedule.
The study was open label.
Primary outcomes were school attendance, fatigue severity, and physical functioning, and were assessed at 6 months with computerised questionnaires.
Analysis was by intention to treat.
Thereafter, all patients were offered FITNET if needed. This trial is registered, number ISRCTN59878666.
Findings
68 of 135 adolescents were assigned to FITNET and 67 to usual care, and 67 and 64, respectively, were analysed.
FITNET was significantly more effective than was usual care for all dichotomised primary outcomes at 6 monthsfull school attendance (50 [75%] vs 10 [16%], relative risk 48, 95% CI 2789; p<00001), absence of severe fatigue (57 [85%] vs 17 [27%], 32, 2149; p<00001), and normal physical functioning (52 [78%] vs 13 [20%], 38, 2363; p<00001).
No serious adverse events were reported.
Interpretation
FITNET offers a readily accessible and highly effective treatment for adolescents with chronic fatigue syndrome.
The results of this study justify implementation on a broader scale.
Funding
Netherlands Organisation for Health Research and Development.
http://www.lancet.com/journals/lancet/article/PIIS0140-6736(12)60025-7/fulltext
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Study protocol - free full text: http://www.biomedcentral.com/1471-2377/11/23
Fatigue In Teenagers on the interNET - The FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666]
Sanne L Nijhof1*, Gijs Bleijenberg2, Cuno SPM Uiterwaal3, Jan LL Kimpen1 and Elise M van de Putte1
* Corresponding author: Sanne L Nijhof s.l.nijhof@umcutrecht.nl
Author Affiliations
1 Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands
2 Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, The Netherlands
3 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
BMC Neurology 2011, 11:23 doi:10.1186/1471-2377-11-23
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2377/11/23
Received: 28 January 2011
Accepted: 19 February 2011
Published: 19 February 2011
Abstract
Background
Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands.
CFS is characterized by unexplained fatigue lasting more than 6 months.
Cognitive Behavioural Therapy (CBT) has proven to be effective.
However, CBT availability for adolescents with CFS is limited and requires special therapeutic skills not always readily available.
An alternative to the face-to-face CBT is FITNET, a web-based therapeutic program designed specifically for adolescents diagnosed with CFS, and their parents.
This new CBT approach appeals to the modern youth, who grow up with internet as their main source of information.
A web-based program offers the opportunity to lower thresholds for the acceptance and realization of healthcare.
This treatment can be activated at any chosen time.
The communication between patient and therapist can elapse asynchronously.
If effective, this web-based program would greatly increase the therapeutic accessibility.
Methods/Design
A randomized clinical trial is currently conducted.
One-hundred-forty adolescents aged 12-18 years diagnosed with CFS will be recruited and randomized to one of two groups: FITNET or usual care.
After 6 months, the usual care group will have access to the FITNET program.
Outcomes will be assessed at baseline, post intervention, and at 6 months follow-up.
Primary outcome measures are school presence, fatigue severity, and physical functioning.
Discussion
The FITNET study is the first randomized clinical trial which evaluates the effect of web-based CBT versus usual care in adolescents with CFS.
The intervention is based on a theoretical existing model of CBT for patients with CFS.
The results of this study will provide information about the possibility and efficacy of web-based CBT for adolescents with CFS and will reveal predictors of efficacy.
Trial registration
ISRCTN: ISRCTN59878666 and ClinicalTrials.gov: NCT00893438
* I gave each sentence its own paragraph.