Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database

CFS/ME National Outcomes Database

Research output: Contribution to journalArticle (Academic Journal)peer-review

34 Citations (Scopus)

Abstract

BACKGROUND: Chronic fatigue syndrome (CFS) is relatively common and disabling. Over 8000 patients attend adult services each year, yet little is known about the outcome of patients attending NHS services.
AIM: Investigate the outcome of patients with CFS and what factors predict
outcome.
DESIGN: Longitudinal patient cohort.
METHODS: We used data from six CFS/ME (myalgic encephalomyelitis) specialist
services to measure changes in fatigue (Chalder Fatigue Scale), physical function
(SF-36), anxiety and depression (Hospital Anxiety and Depression Scale) and pain
(visual analogue pain rating scale) between clinical assessment and 8-20 months
of follow-up. We used multivariable linear regression to investigate baseline
factors associated with outcomes at follow-up. Results: Baseline data obtained at
clinical assessment were available for 1643 patients, of whom 834 (51%) had
complete follow-up data. There were improvements in fatigue [mean difference from assessment to outcome: -6.8; 95% confidence interval (CI) -7.4 to -6.2; P <
0.001]; physical function (4.4; 95% CI 3.0-5.8; P < 0.001), anxiety (-0.6; 95% CI
-0.9 to -0.3; P < 0.001), depression (-1.6; 95% CI -1.9 to -1.4; P < 0.001) and pain (-5.3; 95% CI -7.0 to -3.6; P < 0.001). Worse fatigue, physical function and pain at clinical assessment predicted a worse outcome for fatigue at follow-up. Older age, increased pain and physical function at assessment were associated with poorer physical function at follow-up.
CONCLUSION: Patients who attend NHS specialist CFS/ME services can expect similar improvements in fatigue, anxiety and depression to participants receiving
cognitive behavioural therapy and graded exercise therapy in a recent trial, but
are likely to experience less improvement in physical function. Outcomes were
predicted by fatigue, disability and pain at assessment.
Original languageEnglish
Pages (from-to)567
JournalQJM
Volume106
Issue number6
Early online date28 Mar 2013
DOIs
Publication statusPublished - Jun 2013

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