Comparative Analysis of integrated primary care models versus Standard Care in chronic fatigue syndrome
DOI:
https://doi.org/10.5281/zenodo.22813596Keywords:
chronic fatigue syndrome, myalgic encephalomyelitis, integrated primary care, standard care, cognitive behavioural therapyAbstract
Background: Chronic fatigue syndrome (ME/CFS) is a disabling illness most patients experience within general practice, where management ranges from unstructured standard care to structured, multidisciplinary integrated primary care pathways.
Objective: This review compares integrated primary care models against standard care for adults with ME/CFS across symptom severity, function, quality of life, and health-service utilisation.
Methods: We synthesized randomised controlled trials, Cochrane systematic reviews, guideline evidence syntheses, and comparative cohort studies of cognitive behavioural, graded exercise, pacing-based, and coordinated primary-care-delivered interventions.
Findings: Structured, function-focused interventions outperformed unstructured or specialist-medical-care-only management, with roughly 60% of patients receiving cognitive behavioural or graded exercise therapy meeting improvement thresholds versus 45% receiving specialist care alone; coordinated pathways also reduced low-yield repeat consultation, though a clinically important minority reported worsening with unmodified graded exercise.
Conclusions: Integrated primary care models are supported by a substantial, largely indirect, evidence base for better outcomes and more efficient service use than standard care, provided activity-based components are individualised rather than fixed.
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