Graded Exercise Therapy and Cognitive Behavioural Therapy is OUT!!!

NICE have published their new #MECFS guidelines!

Extracts from the Science for ME press release…

“The National Institute for Health and Care Excellence (NICE, UK) has today, Friday 29 October 2021, published the guideline for #MyalgicEncephalomyelitis (or encephalopathy)/ #chronicfatiguesyndrome: diagnosis and management.”

“The guideline replaces the existing clinical guideline published in 2007 and aims to improve awareness and understanding about ME/CFS, provide guidance on when to suspect it (to enable earlier diagnosis), and includes recommendations on access to care, symptom management and care planning.”

“NICE staff and the members of the guideline committee have worked for over three years to carefully examine the evidence… The guideline is a publication of international significance, providing an example of good practice that will influence ME/CFS care around the world.” – Including here in #NewZealand.

“The guideline makes it clear that graded exercise therapy (GET) should no longer be offered to people with ME/CFS, and that both cognitive behavioural therapy (CBT) and therapies based on physical activity are not curative. This is based on a review of the evidence, which rated the outcomes for studies of these interventions all of low or very low quality. This is a welcome and significant, evidence-based change in approach from the 2007 ME/CFS guideline, in which CBT and GET were central to treatment.”

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• Link to the new NICE guidelines: https://www.nice.org.uk/guidance/ng206

• Link to discussion and information in the Science for ME forum:

https://www.s4me.info/…/uk-nice-2021-me-cfs-guideline…/

Graded exercise therapy (GET) is no longer recommended for ME/CFS.
- https://www.emerge.org.au/gradedexercisetherapyandmecfs
- Statement – CCIS Position on Graded Exercise Therapy
- Statement ‘Global move away from ineffective therapies for ME/CFS’, 21 August 2021
  Emeritus Professor Warren Tate, Biochemistry, University of Otago
- Statement ‘ME/CFS and Exercise’, 2 September 2021
  Dr. Lynette Hodges, Senior Lecturer in Sport and Exercise, Massey University
Cognitive behavioural therapy, CBT, is no longer recommended as a treatment for ME/CFS

M.E. Awareness NZ

It is worth noting that most District Health Boards in New Zealand have updated their clinical guidelines about ME/CFS for GPs and Physicians in their regional Health Pathways platform over the last two years. Most DHBs now base their ME/CFS guidance on the IOM 2015 diagnostic criteria and evidence-based management. This guidance makes it clear that graded exercise therapy is not appropriate for a chronic illness that has an abnormal physiological response to exercise. However, many New Zealand doctors do refer to the NICE guidelines from the UK, so it is important that these have also been updated. Note: The CDC provide extensive information about the IOM 2015 criteria on their website https://www.cdc.gov/me-cfs/about/index.html

Thank you M.E. Awareness NZ for keeping us in the loop