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Tiredness/fatigue in adults - Management
Basis for recommendation
- The recommendations in relation to people with symptoms suggestive of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis or encephalopathy (ME) are based on a National Institute for Health and Clinical Excellence guideline on the diagnosis and management of CFS/ME [National Collaborating Centre for Primary Care, 2007].
- As well as comprehensive assessment, referral to specialist services provides access to cognitive behavioural therapy and graded exercise therapy, which NICE states are 'the interventions for which there is the clearest research evidence of benefit' in people with mild-to-moderate CFS/ME [National Collaborating Centre for Primary Care, 2007].
- The recommendation that referral may be required if any other serious underlying cause is suspected or identified is pragmatic.
- In the absence of published evidence, the recommendation on when to consider referral for people with persistent, unexplained tiredness/fatigue not meeting the criteria for CFS/ME is a compromise between the views of CKS expert reviewers, who were divided on the merits of referring this group of people to secondary care.
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