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Nurse led, home based self help treatment for patients in primary care with chronic fatigue syndrome: randomised controlled trial

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BMJ Publishing group
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Disciplines
  • Design
  • Economics
  • Medicine
  • Psychology

Abstract

bmj-002889dupe 1..12 RESEARCH Nurse led, home based self help treatment for patients in primary care with chronic fatigue syndrome: randomised controlled trial Alison J Wearden, reader in psychology,1 Christopher Dowrick, professor of primary medical care,2 Carolyn Chew-Graham, professor of primary care,3 Richard P Bentall, professor of clinical psychology,4 Richard K Morriss, professor of psychiatry and community mental health,5 Sarah Peters, senior lecturer in psychology,1 Lisa Riste, FINE trial manager,1 Gerry Richardson, senior research fellow in health economics,6,7 Karina Lovell, professor of mental health,8 Graham Dunn, professor of biomedical statistics3 on behalf of the Fatigue Intervention by Nurses Evaluation (FINE) trial writing group and the FINE trial group ABSTRACT Objective To evaluate the effectiveness of homedelivered pragmatic rehabilitation—a programme of gradually increasing activity designed collaboratively by the patient and the therapist—and supportive listening—an approach based on non-directive counselling—for patients in primary care with chronic fatigue syndrome/ myalgic encephalomyelitis or encephalitis (CFS/ME). Design Single blind, randomised, controlled trial. Setting 186 general practices across the north west of England between February 2005 and May 2007. Participants 296 patients aged 18 or over with CFS/ME (median illness duration seven years) diagnosed using the Oxford criteria. Interventions Participants were randomly allocated to pragmatic rehabilitation, supportive listening, or general practitioner treatment as usual. Both therapies were delivered at home in 10 sessions over 18 weeks by one of three adult specialty general nurses who had received four months’ training, including supervised practice, in each of the interventions. GP treatment as usual was unconstrained except that patientswere not to be referred for systematic psychological therapies during the treatment period. Main outcome measures

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