1) I have made a summary of the draft for the new NICE guideline.

It also includes some background info because this could be a historical document for the ME/CFS patient community.

#meawarenesshour https://mecfsskeptic.wordpress.com/2020/11/11/the-new-nice-guideline-a-summary-and-discussion-of-the-draft/

2) While the previous NICE guideline advised graded exercise therapy, the current draft explicitly discourages this approach because of low-quality evidence and multiple reports of harm. #meawarenesshour

3) While the previous guideline focused on expanding the patients’ perceived limits by trying to extend their physical capacity, the new draft takes the principle that patients are “the best judge of their own limits”.

#meawarenesshour

4) The draft also makes clear that cognitive behavior therapy CBT should not be offered as a treatment or cure for ME/CFS. It criticizes the type of CBT that assumes patients have ‘abnormal’ illness beliefs and behaviours as an underlying cause of their ME/CFS.”

#meawarenesshour

5) Instead, the draft says that the type CBT that should be offered (if patients would like that) focuses on supporting patients in managing their symptoms or coping with disability. #meawarenesshour

6) “Be aware there is no current treatment or cure”

The draft makes clear that currently, there is insufficient evidence for supplements, drugs or behavioral interventions to treat ME/CFS.

#meawarenesshour

7) The draft does recommend strategies based on the energy envelope theory. e.g. that patients should be advised: “not to use more energy than they perceive they have − they should plan their daily activity to stay within their energy envelope and not push through activity.”

8) The draft also recommends focusing on early diagnosis and management and adapting to the patient’s need (for example with home visits for severe patients).

#meawarenesshour