CBT has been found to help improve symptoms and coping strategies
Myalgic encephalomyelitis (ME) the illness also known as chronic fatigue syndrome, affects some 250,000 people in the UK. Symptoms include a live-changing severe fatigue, painful muscles, disrupted sleep and poor memory and concentration. Although viral infection is linked with its onset, no one is sure what causes it. New research indicates that cognitive behavioural therapy (CBT) is the most cost-effective treatment for the disease, along with medical care.
Researchers from King's College London looked at data relating to patients' responses to different treatments and then used criteria from the NHS to ascertain which treatment gave the best value for money. These criteria are based on the years a person lives in good health. If a treatment costs less than £20,000 per year and achieves 'good health' for a patient during that time, it's considered good value. CBT was found to be good value and, although it can’t cure ME it has been found to help improve symptoms and coping strategies.
Graded exercise therapy (GET), where physical activity is tailored to suit the individual and gradually increased over a long period of time, was also found to be of good value.
However, one type of treatment offered to ME sufferers – adaptive pacing therapy – was not found to offer value for money. This is a specific strategy that involves the patient aiming for a balance between rest and activity, enabling them to live within the constraints of the illness. For each year of quality life, CBT costs an estimated £18,000; GET £24,000; and APT £55,000. This means the first two are classifiable as cost effective so it's hoped that the NHS will now invest further in providing them for people with ME.
Understandably, ME patients argue that available treatment shouldn't be based on cost and, according to the ME Association, these study results do not paint a complete picture. "The feedback we get at the ME Association regarding which treatments work best do not match the results of this study," says medical adviser, Dr Charles Shepherd. "Going by our own members' feedback, pacing is by far the most effective and acceptable form of treatment; many members find CBT to be ineffective and GET makes the condition worse in around half of individuals. What we need is more research into the biomedical causes of this illness and forms of treatment based on that."