Persistent Physical Symptoms Reduction INtervention: a System Change & Evaluation (PRINCE Primary)

[Forbin]

I've heard that this study is like a beautiful cruise ship...

Treatment Investigation Targeting Assumed Non- Illnesses with CBT

 

[chipmunk1]

You just have to define "believing the car runs properly" as slight improvement on a questionnaire. If every week, a compassionate mechanic tells the car owner that these strange engine noises are perfectly normal and that there is nothing to worry about, I'm pretty sure that will result in a shift in questionnaire answers towards the desired results.

and then the story ends with a fatal car accident.

 

[Cheshire]

and then the story ends with a fatal car accident.

Caused by the driver's anxiety and errors generated by him thinking there's something wrong with his car...

 

[daisybell]

Caused by the driver's anxiety and errors generated by him thinking there's something wrong with his car...

Because the car can't have an accident on its own - therefore the accident must be the driver's fault.....

 

[Cheshire]

Just wanted to add this wonderful acronym by Vincent Deary, for posterity, because it deserves it:

SMART (Specific, Measurable, Achievable, Realistic and Time orientated) targets and managing activity

From ABC of medically unexplained symptoms https://t.co/0e4hl0zgL2

 

[Chrisb]

One can see why they never find time to acquire the skills to do any of the difficult stuff.

 

[worldbackwards]

One can see why they never find time to acquire the skills to do any of the difficult stuff.

When you have that kind of skill set, why would you ever want to?

 

[Valentijn]

This comment was posted on the recent guardian article:

 

[Valentijn]

My experience with a physiotherapist is that he knew enough about the human body to refrain from pushing me. It was the "relaxation therapist" who made me crash by insisting I do an exercise involving tensing and relaxing muscles, and it was the psychologist who encouraged me to "get out more" and avoid disability aids (I didn't follow her advice ).

It's a bit scary that they can't get physiotherapists willing to support them in providing GET in the PRINCE trial, and the psychologists are pressing on despite their complete lack of physiotherapy training.

 

[Chrisb]

Cannot like your (EDIT first) post Val, you know what I mean.

Given what we now know about the analysis of the PACE data, and given that this was already known to the researchers, it would be interesting to know what passed for informed consent in this case. There is a clear statement from the parent that they were not aware of the "PACE trial fiasco".

This could all get very expensive. And it was all done to save money.

 

[worldbackwards]

My experience with a physiotherapist is that he knew enough about the human body to refrain from pushing me.

My experience with a physio was that they didn't have the faintest idea what they were doing with ME; for example, recommending leg raising exercises for someone in bed 22/3 hours a day, or ordering me to push directly through symptoms in the light of previous experience of significant setbacks.

The danger is probably not so much with the physio/psychologist split, but the more depressingly familiar pragmatic/doctrinaire one. Although I suspect that you're right that CBTs are more likely to fall into the latter category than the former.

 

[Esther12]

Not important, but I just noticed that while the PRINCE secondary care trial has been recruiting patients for a while, the PRINCE primary care page says that it still is not, despite apparently being due to finish soon. Wonder what's going on there?

Estimated Primary Completion Date: March 2017

Primary: https://clinicaltrials.gov/ct2/show/NCT02444520
Secondary: https://clinicaltrials.gov/ct2/show/NCT02426788

This trial design really looks poor. Are they hoping to get away with PACE II, but this time for 20-40% or patients?

 

[Lucibee]

Missing More: After Research Trial (ie, PRINCE secondary trial)

This makes me really quite cross