CBT and GET are cost effective treatments for chronic fatigue syndrome

Exercise and behavioural therapies are the most cost effective and successful ways to treat chronic fatigue syndrome, according to the latest results from the Pace trial.

Around 250,000 people in the UK suffer from chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME). It causes a persistent fatigue that affects everyday life, and doesn’t go away with sleep or rest.

The Pace trial began in 2005 and recruited 640 patients. It compared four of the main treatments available for people with CFS/ME, specialist medical care, cognitive behavioural therapy (CBT), graded exercise therapy (GET) and adaptive pacing therapy (APT).

Results from the trial published last year showed that cognitive behavioural therapy and graded exercise therapy were the most effective treatments for ME.

But this study provoked anger from patients’ groups, who argued that adaptive pacing therapy - learning to live within limits- is better and safer.

Now, researchers have shown that exercise and behavioural therapies have the potential to save the economy millions of pounds.

Writing in the journal PLoS ONE, the scientists looked at the same 640 patients recruited for the trial back in 2005. They compared improvements in levels of fatigue and activity with the cost to the NHS of providing treatments.

The study found that only cognitive behavioural therapy and graded exercise therapy could be considered cost-effective after taking in the wider cost of chronic fatigue syndrome to society. Adaptive pacing therapy was not judged to be good value.

Researchers based their conclusions on the same criteria used by the NHS efficiency watchdog, the National Institute for health and Clinical Excellence.

Professor Paul McCrone, a health economist from King's College London, said: "There is now a strong case for the NHS to invest in providing these therapies."

Professor Michael Sharpe, from Oxford University, said: "This new evidence should encourage health service commissioners to provide these treatments to all those patients who need them."