Purpose: To assess the efficacy of fatigue self-management for severe chronic fatigue syndrome (CFS).
Methods: This randomized trial enrolled 137 patients with severe CFS.
Participants were randomized to one of three conditions:
- fatigue self-management with web diaries and actigraphs (FSM:ACT);
- fatigue self-management with less expensive paper diaries and pedometers (FSM:CTR);
- or an usual care control condition (UC).
The primary outcome assessed fatigue severity at 3-month follow-up. Analysis was by intention-to-treat.
Results: At 3-month follow-up, the FSM:CTR condition showed significantly greater reduction in fatigue severity compared to UC (p=.03; d=.58).
No significant improvement was found at 12-month follow-up for the FSM:ACT or the FSM:CTR condition as compared to UC (p>.10). The combined active treatment conditions revealed significantly reduced fatigue at 3-month follow-up (p=.03), but not at 12-month follow-up (p=.24) compared to UC. Clinically significant improvements were found for 24-28% of the intervention groups as compared to 9% of the UC group. Attrition at 12-month follow-up was low (<8%).
Conclusion: Home-based self-management for severe CFS appeared to be less effective in comparison to findings reported for higher functioning groups. Home-based management may be enhanced by remotely delivered interventional feedback.
Efficacy of two delivery modes of behavioral self-management in severe chronic fatigue syndrome, by Fred Friedberg, Jenna Adamowicz, Indre Caikauskaite, Viktoria Seva & Anthony Napoli in Fatigue: Biomedicine, Health & Behavior Vol 4, no.3, pp 158-174 [Published online: 29 Jul 2016]