August 23, 2013 - A study by Fred Friedberg, PhD and colleagues demonstrated that a brief two-session self-management program administered by nurses in a primary care practice can improve the lives of people with unexplained chronic fatigue or chronic fatigue syndrome. In a randomized controlled trial, Dr. Friedberg and his colleagues helped a majority of patients who completed the program achieve significant reductions in the impact of fatigue on functioning at both 3-month and 12-month intervals. Patients who received usual care or an intervention not involving self-management did not experience similar results.
The effective protocol was an adaptation of a 12-session intervention developed by Dr. Friedberg. In the current study, primary care nurses met with their patients in two one-hour sessions to educate them about chronic fatigue, the principles of self-management and effective coping strategies. Patients were also asked to read a 61-page booklet written by Dr. Friedberg and to keep a Web diary about their activities, symptoms and stress levels.
A total of 111 patients with medically unexplained chronic fatigue were randomly divided into three groups. A third received the active intervention; a third received usual care; and a third received two sessions of emotional support and symptom monitoring without being trained in self-management. At the beginning of the study, most patients had high fatigue impact scores. At the end of 12 months, 53% of those who received self-management training exhibited clinically significant reductions in the impact of fatigue on functioning compared with 17% and 14% in the two control groups.
The long-range objective of this and companion studies being conducted by Dr. Friedberg is to develop an easy-access cost-effective behavioral self-management intervention in primary care to help patients with medically unexplained chronic fatigue.
The article, titled Chronic Fatigue Self-Management in Primary Care: A Randomized Trial, was published online before print on August 6, 2013 in Psychosomatic Medicine.
