-
1دورية أكاديمية
المؤلفون: White, Peter, Abbey, Susan, Angus, Brian, Ball, Harriet A, Buchwald, Dedra S, Burness, Christine, Carson, Alan J, Chalder, Trudie, Clauw, Daniel J, Coebergh, Jan, David, Anthony S, Dworetzky, Barbara A, Edwards, Mark J, Espay, Alberto J, Etherington, John, Fink, Per, Flottorp, Signe, Garcin, Béatrice, Garner, Paul, Glasziou, Paul, Hamilton, Willie, Henningsen, Peter, Hoeritzauer, Ingrid, Husain, Mujtaba, Huys, Anne-Catherine ML, Knoop, Hans, Kroenke, Kurt, Lehn, Alexander, Levenson, James L, Little, Paul, Lloyd, Andrew, Madan, Ira, van der Meer, Jos WM, Miller, Alastair, Murphy, Maurice, Nazareth, Irwin, Perez, David L, Phillips, Wendy, Reuber, Markus, Rief, Winfried, Santhouse, Alastair, Serranova, Tereza, Sharpe, Michael, Stanton, Biba, Stewart, Donna E, Stone, Jon, Tinazzi, Michele, Wade, Derick T, Wessely, Simon C, Wyller, Vegard, Zeman, Adam
المصدر: Journal of Neurology, Neurosurgery and Psychiatry (2023) (In press).
مصطلحات موضوعية: CHRONIC FATIGUE SYNDROME, RANDOMISED TRIALS, REHABILITATION
الوصف: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling long-term condition of unknown cause. The National Institute for Health and Care Excellence (NICE) published a guideline in 2021 that highlighted the seriousness of the condition, but also recommended that graded exercise therapy (GET) should not be used and cognitive-behavioural therapy should only be used to manage symptoms and reduce distress, not to aid recovery. This U-turn in recommendations from the previous 2007 guideline is controversial.We suggest that the controversy stems from anomalies in both processing and interpretation of the evidence by the NICE committee. The committee: (1) created a new definition of CFS/ME, which 'downgraded' the certainty of trial evidence; (2) omitted data from standard trial end points used to assess efficacy; (3) discounted trial data when assessing treatment harm in favour of lower quality surveys and qualitative studies; (4) minimised the importance of fatigue as an outcome; (5) did not use accepted practices to synthesise trial evidence adequately using GRADE (Grading of Recommendations, Assessment, Development and Evaluations trial evidence); (6) interpreted GET as mandating fixed increments of change when trials defined it as collaborative, negotiated and symptom dependent; (7) deviated from NICE recommendations of rehabilitation for related conditions, such as chronic primary pain and (8) recommended an energy management approach in the absence of supportive research evidence.We conclude that the dissonance between this and the previous guideline was the result of deviating from usual scientific standards of the NICE process. The consequences of this are that patients may be denied helpful treatments and therefore risk persistent ill health and disability.
وصف الملف: text
العلاقة: https://discovery.ucl.ac.uk/id/eprint/10173669/1/David_NICE-CFSME-eight-flaws---revision-v2.2-clean.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10173669Test/
-
2دورية أكاديمية
المؤلفون: Chalder, Trudie, Patel, Meenal, Hotopf, Matthew, Moss-Morris, Rona, Ashworth, Mark, Watts, Katie, David, Anthony S., Mccrone, Paul, Husain, Mujtaba, Garrood, Toby, James, Kirsty, Landau, Sabine, Carnemolla, Alisia, Armeanca, Sorina, Couch, Elyse, Ferreira, Nicola, Robertson, Jennifer, Patel, Shinal, Fisher-Smith, Paige, Childs, Abigale, Turner, Richard, Mccormack, David, Willis, Claire, Simiao, Fabio, Britton, Tom, Stanton, Biba, Ng, Nora, Cope, Andy, Subesinghe, Sujith, Bahadur, Sardar, Bjarnason, Ingvar, Chung-Faye, Guy, Chatu, Sukh, Pathmanathan, Kumar, Kirkham, Bruce, Kent, Alexandra, Birring, Surrinder, Warwick, Geoffrey, Sanna, Giovanni, Zebouni, Luay, Hull, Dobrina, Hughes, Catherine, Dubois, Patrick, Hayee, Bu, Coltart, Iona, Bardsley-Ball, Andrea
المصدر: Chalder , T , Patel , M , Hotopf , M , Moss-Morris , R , Ashworth , M , Watts , K , David , A S , Mccrone , P , Husain , M , Garrood , T , James , K , Landau , S , Carnemolla , A , Armeanca , S , Couch , E , Patel , M , Watts , K , Ferreira , N , Robertson , J , Patel , S , Fisher-Smith , P , Childs , A , Turner , R , Mccormack , D , Willis , ....
مصطلحات موضوعية: Cognitive behavioural therapy (CBT), medically unexplained symptoms, persistent physical symptoms, randomised controlled trial (RCT), secondary medical care, transdiagnostic
الوصف: Background Medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS) are debilitating to patients. As many specific PPS syndromes share common behavioural, cognitive, and affective influences, transdiagnostic treatments might be effective for this patient group. We evaluated the clinical efficacy and cost-effectiveness of a therapist-delivered, transdiagnostic cognitive behavioural intervention (TDT-CBT) plus (+) standard medical care (SMC) v. SMC alone for the treatment of patients with PPS in secondary medical care. Methods A two-arm randomised controlled trial, with measurements taken at baseline and at 9, 20, 40- and 52-weeks post randomisation. The primary outcome measure was the Work and Social Adjustment Scale (WSAS) at 52 weeks. Secondary outcomes included mood (PHQ-9 and GAD-7), symptom severity (PHQ-15), global measure of change (CGI), and the Persistent Physical Symptoms Questionnaire (PPSQ). Results We randomised 324 patients and 74% were followed up at 52 weeks. The difference between groups was not statistically significant for the primary outcome (WSAS at 52 weeks: estimated difference -1.48 points, 95% confidence interval from -3.44 to 0.48, p = 0.139). However, the results indicated that some secondary outcomes had a treatment effect in favour of TDT-CBT + SMC with three outcomes showing a statistically significant difference between groups. These were WSAS at 20 weeks (p = 0.016) at the end of treatment and the PHQ-15 (p = 0.013) and CGI at 52 weeks (p = 0.011). Conclusion We have preliminary evidence that TDT-CBT + SMC may be helpful for people with a range of PPS. However, further study is required to maximise or maintain effects seen at end of treatment.
الإتاحة: https://doi.org/10.1017/S0033291721001793Test
https://kclpure.kcl.ac.uk/portal/en/publications/35ff3423-8439-4eb2-8486-8bc6b29dc1bbTest
http://www.scopus.com/inward/record.url?scp=85107350680&partnerID=8YFLogxKTest -
3دورية أكاديمية
المؤلفون: Chalder, Trudie, Patel, Meenal, James, Kirsty, Hotopf, Matthew, Moss-Morris, Rona, Ashworth, Mark, Watts, Katie, David, Anthony S., Husain, Mujtaba
المصدر: Chalder , T , Patel , M , James , K , Hotopf , M , Moss-Morris , R , Ashworth , M , Watts , K , David , A S & Husain , M 2021 , ' PRINCE Secondary : Transdiagnostic cognitive behaviour therapy for persistent physical symptoms ' , Psychological Medicine . https://doi.org/10.1017/S0033291721003615Test
الإتاحة: https://doi.org/10.1017/S0033291721003615Test
https://kclpure.kcl.ac.uk/portal/en/publications/bb04e8d5-22ee-44b2-a9e5-75aa713df6faTest
http://www.scopus.com/inward/record.url?scp=85114852995&partnerID=8YFLogxKTest -
4دورية أكاديمية
المؤلفون: Rogers, Jonathan, Collins, George, Husain, Mujtaba, Docherty, Mary
المصدر: Clinical Medicine ; volume 21, issue 1, page 37-43 ; ISSN 1470-2118
الإتاحة: https://doi.org/10.7861/clinmed.2020-0934Test
https://api.elsevier.com/content/article/PII:S1470211824033694?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1470211824033694?httpAccept=text/plainTest -
5دورية أكاديمية
المؤلفون: Husain, Mujtaba, Chalder, Trudie
المصدر: Clinical Medicine ; volume 21, issue 1, page 13-18 ; ISSN 1470-2118
الإتاحة: https://doi.org/10.7861/clinmed.2020-0947Test
https://api.elsevier.com/content/article/PII:S1470211824033669?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1470211824033669?httpAccept=text/plainTest -
6دورية أكاديمية
المؤلفون: Patel, Meenal, James, Kirsty, Moss-Morris, Rona, Ashworth, Mark, Husain, Mujtaba, Hotopf, Matthew, David, Anthony S., McCrone, Paul, Landau, Sabine, Chalder, Trudie, Ferreira, Nicola, Watts, Katie, Turner, Richard, Carnemolla, Alisia, Robertson, Jennifer, Patel, Shinal, Frank, Philipp, Fisher-Smith, Paige, Childs, Abigale, Mosweu, Iris, Willis, Claire, Simiao, Fabio
المساهمون: Guy's and St Thomas' Charity
المصدر: BMC Family Practice ; volume 21, issue 1 ; ISSN 1471-2296
مصطلحات موضوعية: Family Practice
الوصف: Background Patients continue to suffer from medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS). General practitioners (GPs) play a key role in the management of PPS and require further training. Patients are often frustrated with the care they receive. This study aims to assess the acceptability of an ‘integrated GP care’ approach which consists of offering self-help materials to patients with PPS and offering their GPs training on how to utilise cognitive behavioural skills within their consultations, as well as assessing the feasibility of conducting a future trial in primary care to evaluate its benefit. Methods A feasibility cluster randomised controlled trial was conducted in primary care, South London, UK. GP practices (clusters) were randomly allocated to ‘integrated GP care plus treatment as usual’ or ‘treatment as usual’. Patients with PPS were recruited from participating GP practices before randomisation. Feasibility parameters, process variables and potential outcome measures were collected at pre-randomisation and at 12- and 24-weeks post-randomisation at cluster and individual participant level. Results Two thousand nine hundred seventy-eight patients were identified from 18 GP practices. Out of the 424 patients who responded with interest in the study, 164 fully met the eligibility criteria. One hundred sixty-one patients provided baseline data before cluster randomisation and therefore were able to participate in the study. Most feasibility parameters indicated that the intervention was acceptable and a future trial feasible. 50 GPs from 8 GP practices (randomised to intervention) attended the offer of training and provided positive feedback. Scores in GP knowledge and confidence increased post-training. Follow-up rate of patients at 24 weeks was 87%. However estimated effect sizes on potential clinical outcomes were small. Conclusions It was feasible to identify and recruit patients with PPS. Retention rates of participants up to 24 weeks were ...
-
7دورية أكاديمية
المؤلفون: Chalder, Trudie, Patel, Meenal, James, Kirsty, Hotopf, Matthew, Frank, Philipp, Watts, Katie, McCrone, Paul, David, Anthony, Ashworth, Mark, Husain, Mujtaba, Garrood, Toby, Moss-Morris, Rona, Landau, Sabine
المصدر: BMC Psychiatry ; volume 20, issue 1 ; ISSN 1471-244X
مصطلحات موضوعية: Psychiatry and Mental health
الوصف: An amendment to this paper has been published and can be accessed via the original article.
-
8دورية أكاديمية
المؤلفون: Patel, Meenal, James, Kirsty, Moss-Morris, Rona, Ashworth, Mark, Husain, Mujtaba, Hotopf, Matthew, David, Anthony S., McCrone, Paul, Landau, Sabine, Chalder, Trudie
المصدر: BMC Family Practice ; volume 21, issue 1 ; ISSN 1471-2296
مصطلحات موضوعية: Family Practice
الوصف: An amendment to this paper has been published and can be accessed via the original article.
-
9دورية أكاديمية
المؤلفون: Chalder, Trudie, Patel, Meenal, Hotopf, Matthew, Moss-Morris, Rona, Ashworth, Mark, Watts, Katie, David, Anthony S., McCrone, Paul, Husain, Mujtaba, Garrood, Toby, James, Kirsty, Landau, Sabine
المصدر: Psychol Med
مصطلحات موضوعية: Original Article, psy, socio
الوصف: BACKGROUND: Medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS) are debilitating to patients. As many specific PPS syndromes share common behavioural, cognitive, and affective influences, transdiagnostic treatments might be effective for this patient group. We evaluated the clinical efficacy and cost-effectiveness of a therapist-delivered, transdiagnostic cognitive behavioural intervention (TDT-CBT) plus (+) standard medical care (SMC) v. SMC alone for the treatment of patients with PPS in secondary medical care. METHODS: A two-arm randomised controlled trial, with measurements taken at baseline and at 9, 20, 40- and 52-weeks post randomisation. The primary outcome measure was the Work and Social Adjustment Scale (WSAS) at 52 weeks. Secondary outcomes included mood (PHQ-9 and GAD-7), symptom severity (PHQ-15), global measure of change (CGI), and the Persistent Physical Symptoms Questionnaire (PPSQ). RESULTS: We randomised 324 patients and 74% were followed up at 52 weeks. The difference between groups was not statistically significant for the primary outcome (WSAS at 52 weeks: estimated difference −1.48 points, 95% confidence interval from −3.44 to 0.48, p = 0.139). However, the results indicated that some secondary outcomes had a treatment effect in favour of TDT-CBT + SMC with three outcomes showing a statistically significant difference between groups. These were WSAS at 20 weeks (p = 0.016) at the end of treatment and the PHQ-15 (p = 0.013) and CGI at 52 weeks (p = 0.011). CONCLUSION: We have preliminary evidence that TDT-CBT + SMC may be helpful for people with a range of PPS. However, further study is required to maximise or maintain effects seen at end of treatment.
-
10دورية أكاديمية
المؤلفون: Patel, Meenal, James, Kirsty, Moss-Morris, Rona, Husain, Mujtaba, Ashworth, Mark, Frank, Philipp, Ferreira, Nicola, Mosweu, Iris, McCrone, Paul, Hotopf, Matthew, David, Anthony, Landau, Sabine, Chalder, Trudie
مصطلحات موضوعية: R Medicine
الوصف: Introduction Persistent physical symptoms (PPS), also known as medically unexplained symptoms are associated with profound physical disability, psychological distress and high healthcare costs. England's annual National Health Service costs of attempting to diagnose and treat PPS amounts to approximately £3 billion. Current treatment relies on a positive diagnosis, life-style advice and drug therapy. However, many patients continue to suffer from ongoing symptoms and general practitioners (GPs) are challenged to find effective treatments. Training GPs in basic cognitive behavioural skills and providing self-help materials to patients could be useful, but availability in primary care settings is limited. Methods and analysis A cluster randomised waiting list, controlled trial will be conducted to assess the feasibility of an integrated approach to care in general practice. Approximately 240 patients with PPS will be recruited from 8 to 12 GP practices in London. GP practices will be randomised to 'integrated GP care plus treatment as usual' or waiting list control. Integrated GP care plus treatment as usual will include GP training in cognitive behavioural skills, GP supervision and written and audio visual materials for both GPs and participants. The primary objectives will be assessment of trial and intervention feasibility. Secondary objectives will include estimating the intracluster correlation coefficient for potential outcome measures for cluster effects in a sample size calculation. Feasibility parameters and identification of suitable primary and secondary outcomes for future trial evaluations will be assessed prerandomisation and at 12 and 24 weeks' postrandomisation, using a mixed-methods approach. Ethics and dissemination Ethical approval was granted by the Camberwell St Giles Ethics Committee. Results will be disseminated via peer-reviewed publications and conference presentations. This trial will inform researchers, clinicians, patients and healthcare providers about the feasibility and potential ...
وصف الملف: text
العلاقة: http://eprints.lse.ac.uk/106168/1/e025513.full.pdfTest; Patel, Meenal, James, Kirsty, Moss-Morris, Rona, Husain, Mujtaba, Ashworth, Mark, Frank, Philipp, Ferreira, Nicola, Mosweu, Iris, McCrone, Paul, Hotopf, Matthew, David, Anthony, Landau, Sabine and Chalder, Trudie (2019) Persistent physical symptoms reduction intervention: a system change and evaluation (PRINCE) - integrated GP care for persistent physical symptoms: protocol for a feasibility and cluster randomised waiting list, controlled trial. BMJ Open, 9 (7). ISSN 2044-6055
