{"id":17917,"date":"2018-08-30T09:14:36","date_gmt":"2018-08-30T09:14:36","guid":{"rendered":"http:\/\/wames.org.uk\/cms-english\/?p=17917"},"modified":"2018-08-30T09:14:36","modified_gmt":"2018-08-30T09:14:36","slug":"afme-apologises-for-its-role-in-the-pace-trial-clarifies-its-change-of-position","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/afme-apologises-for-its-role-in-the-pace-trial-clarifies-its-change-of-position\/","title":{"rendered":"AfME apologises for its role in the PACE trial &#038; clarifies its change of position"},"content":{"rendered":"<p><strong>Action for M.E. statement on: The PACE trial and behavioural treatments for M.E.<\/strong><\/p>\n<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"alignleft size-full wp-image-17918 lazyload\" data-src=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2018\/08\/AfME-logo.png?resize=268%2C102\" alt=\"\" width=\"268\" height=\"102\" data-srcset=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2018\/08\/AfME-logo.png?w=268&amp;ssl=1 268w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2018\/08\/AfME-logo.png?resize=150%2C57&amp;ssl=1 150w\" data-sizes=\"(max-width: 268px) 100vw, 268px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 268px; --smush-placeholder-aspect-ratio: 268\/102;\" \/>On 29th August 2018 Action for ME published a statement explaining the charity&#8217;s role in the PACE trial and apologising for their role in contributing to the stigma and misunderstanding of ME.\u00a0 Excerpts from the statement:<\/p>\n<p>Sonya Chowdhury, our Chief Executive since September 2012, says:<\/p>\n<p style=\"padding-left: 30px;\">&#8216;By\u00a0having a role on the Steering Committee and Management Group, there was<br \/>\na de facto endorsement of the use of \u00a35m of research funding to<br \/>\nfocus on behavioural treatments. Neither I nor the current Board of<br \/>\nTrustees would agree to do this now, as reflected by our current<br \/>\nresearch strategy, the focus of which is collaborative biomedical<br \/>\nresearch.<\/p>\n<p style=\"padding-left: 30px;\">&#8216;I am sorry that the charity did not advocate for this considerable<br \/>\nlevel of funding to be invested in biomedical research instead. It was<br \/>\nnever our intention to contribute to any stigma or misunderstanding<br \/>\nabout the illness and I sincerely apologise to those who feel that, in<br \/>\nnot speaking out sooner and more strongly, we have caused harm.<\/p>\n<p style=\"padding-left: 30px;\">&#8216;Our position on recommending treatment and management approaches for<br \/>\nM.E. is set out below and, over the coming months, we will review all<br \/>\nour printed and online information to reflect this. This is no small<br \/>\ntask, but one that the team will prioritise and complete as quickly and<br \/>\ncomprehensively as we can.<\/p>\n<p style=\"padding-left: 30px;\">&#8216;We will learn from our past mistakes. We will continue to provide<br \/>\npractical support to our Supporting Members and others with M.E., to<br \/>\nchallenge the stigma and neglect they experience, and work with<br \/>\nprofessionals and policy-makers to transform the lives of children,<br \/>\nyoung people and adults with M.E. in the future.&#8217;<\/p>\n<p>A summary of our position<\/p>\n<p>Action for M.E. does not support any treatment approach:<\/p>\n<ul>\n<li>based on the deconditioning hypothesis<\/li>\n<li>in which patients&#8217; legitimate concerns about the consequences of<br \/>\nexercise are dismissed or ignored.<\/li>\n<\/ul>\n<p>We fully support treatment approaches which:<\/p>\n<ul>\n<li>aim to reduce and stabilise symptoms before any appropriate increase<br \/>\nin activity levels is attempted<\/li>\n<li>put the person with M.E.\/CFS in charge of the aims and goals of the<br \/>\noverall management plan.<\/li>\n<\/ul>\n<p>We would like to see:<\/p>\n<ul>\n<li>clarity from specialist NHS M.E.\/CFS services about the approaches<br \/>\nthey offer, and the theoretical basis behind them, to help patients make<br \/>\ninformed decisions about the treatments they are being offered<\/li>\n<li>health services and commissioners working directly with people<br \/>\naffected by M.E. to develop patient-led services<\/li>\n<li>good-quality, independent evaluation of the programmes being offered<br \/>\nby specialist NHS M.E.\/CFS services.&#8217;<\/li>\n<\/ul>\n<p><strong>The statement then goes on to clarify AfME&#8217;s position on Pacing.<\/strong><\/p>\n<p style=\"padding-left: 30px;\">In its guidance on therapy and symptom management, the British<br \/>\nAssociation for CFS\/M.E. does not refer to APT and\/or pacing. Instead,<br \/>\nit offers &#8216;pragmatic recommendations from experienced clinicians to<br \/>\nguide practice when seeing adults with CFS\/M.E., where specialist<br \/>\nCFS\/M.E. CBT and GET therapists are not available\/appropriate [&#8230;]<br \/>\nEvidence-based therapies emphasize a therapeutic relationship that<br \/>\nenables a graded increase in activity and a process to explore barriers<br \/>\nto this increase.&#8217;<\/p>\n<p style=\"padding-left: 30px;\">According to BACME, specialist NHS M.E.\/CFS services should advocate<br \/>\ncollaborative work, patient-led goals and support to stabilise<br \/>\nphysiological patterns of rest, sleep, movement and diet. At the same<br \/>\ntime, psychological\/emotional support should be offered, aimed at<br \/>\nsupporting patients to come to terms with being diagnosed and\/or living<br \/>\nwith the condition, and to understand the factors and behaviours (eg.<br \/>\ndoing too much) that jeopardises that stabilisation.<\/p>\n<p>We fully support this approach, and would add that:<\/p>\n<ul>\n<li>&#8216;this is best achieved through pacing that utilizes energy<br \/>\nconservation techniques mindful of heart rate limits. Only then can<br \/>\ncareful training of the anaerobic energy system, (ie, improving the<br \/>\nbody&#8217;s tolerance for and ability to clear lactate while increasing ATP<br \/>\nin resting muscle) be initiated.&#8217; (Van Ness et al, Workwell Foundation,<br \/>\nMay 2018)<\/li>\n<li>&#8216;healthcare professionals should recognise that the person with CFS\/ME<br \/>\nis in charge of the aims and goals of the overall management plan. The<br \/>\npace of progression throughout the course of any intervention should be<br \/>\nmutually agreed.&#8217; (NICE guideline for M.E.\/CFS, 2007)<\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.actionforme.org.uk\/news\/pace-trial-and-behavioural-treatments-for-me\/\" target=\"_blank\" rel=\"noopener\">Read the full statment<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Action for M.E. statement on: The PACE trial and behavioural treatments for M.E. On 29th August 2018 Action for ME published a statement explaining the charity&#8217;s role in the PACE trial and apologising for their role in contributing to the &hellip; <a href=\"https:\/\/wames.org.uk\/cms-english\/afme-apologises-for-its-role-in-the-pace-trial-clarifies-its-change-of-position\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[812,2024,560,2063,3641,11,426,10,481,310,405,2211],"class_list":["post-17917","post","type-post","status-publish","format-standard","hentry","category-news","tag-action-for-me","tag-adaptive-pacing","tag-afme","tag-bacme","tag-british-association-for-cfsme","tag-cbt","tag-cognitive-behavioural-therapy","tag-get","tag-graded-exercise-therapy","tag-pace-trial","tag-pacing","tag-sonya-chowdhury"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-4EZ","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/17917","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=17917"}],"version-history":[{"count":2,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/17917\/revisions"}],"predecessor-version":[{"id":17920,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/17917\/revisions\/17920"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=17917"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=17917"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=17917"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}