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Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services

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By R. M. Parslow et al.

Abstract
 

BACKGROUND: Paediatric Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) is relatively common and disabling. Improving treatment requires the development of Patient Reported Outcome Measures (PROMs) that enable clinicians and researchers to collect patient-centred evidence on outcomes. Health professionals are well placed to provide clinical insight into the condition, its treatment and possible outcomes. This study aimed to understand the perspectives of specialist paediatric CFS/ME health professionals and identify outcomes that are clinically important.

METHODS: Focus groups and interviews were held with 15 health professionals involved in the care of children with CFS/ME from the four largest specialist paediatric CFS/ME services in the NHS in England. A range of clinical disciplines were included and experience in paediatric CFS/ME ranged from 2 months to 25 years. Ten participants (67%) were female. Focus groups and interviews were recorded, transcribed verbatim and data were analysed using thematic analysis.

RESULTS All health professionals identified the impact of CFS/ME across multiple aspects of health. Health professionals described four areas used to assess the severity of the illness and outcome in children: 1) symptoms; 2) physical function; 3) participation (school, activities and social life); and 4) emotional wellbeing. They also described the complexity of the condition, contextual factors and considerations for treatment to help children to cope with the condition.

CONCLUSIONS: Clinically important outcomes in paediatric CFS/ME involve a range of aspects of health. Health professionals consider increases in physical function yet maintaining school functioning and participation more widely as important outcomes from treatment. The results are similar to those described by children in a recent study and will be combined to develop a new child-specific PROM that has strong clinical utility and patient relevance.

Source: Parslow RM, Shaw A, Haywood K, Crawley E. Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services. BMC Pediatr. 2017 Feb 1;17(1):43. doi: 10.1186/s12887-017-0799-7.

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One thought on “Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): perspectives of health professionals from specialist services”

  1. dfwmom says:

    “Health professionals consider increases in physical function yet maintaining school functioning and participation more widely as important outcomes from treatment.”

    What “treatment”? Currently, there are few or no effective treatments for Fibromyalgia in chidlren. If you push children to increase physical function, school function and participation, when you have not actually succeeded in mitigating the symptoms of the illness, you are placing the child under extreme stress and creating a situation that will not be sustainable, long term. For children with Fibromyalgia, the solution is often to DECREASE participation in school or physical function, so at least some extent, to create a sustainable situation for the child, until the medical community can come up with a treatment that WORKS. Simply pretending a child is not ill and pushing the child harder and hard to behave “normally” is not “treatment”. It is wishful thinking.

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