Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome.
Lewith, G, Stuart, B, Chalder, T et al. · Journal of psychosomatic research · 2016 · DOI
Quick Summary
This study looked at how many people with ME/CFS use complementary and alternative medicine (CAM)—such as herbal supplements, acupuncture, or other non-standard treatments—and whether these helped their symptoms. Researchers found that 70% of study participants used some form of CAM at the start, but using CAM was not associated with meaningful improvements in fatigue or physical function over the course of the study.
Why It Matters
This study provides evidence-based data on CAM prevalence in ME/CFS populations and whether these commonly-used treatments produce clinically meaningful benefits. Understanding which interventions do or do not help patients make better-informed decisions about their care and resource allocation.
Observed Findings
70% of participants used some form of CAM at baseline; this decreased to 64% at 52 weeks.
31% of participants were actively seeing a CAM practitioner at baseline; 64% were taking a CAM medication.
Female gender and local ME group membership were independently associated with CAM use at both timepoints.
CAM use at baseline was associated with a mean 4.10-point improvement in SF-36 physical function score at 52 weeks, which did not meet the threshold for clinically important difference.
No significant associations were found between any CAM use and fatigue outcomes at baseline or 52 weeks.
Inferred Conclusions
Complementary and alternative medicine use is common in CFS patients, particularly among women and those with community support group involvement.
CAM use was not associated with clinically meaningful improvements in the trial's primary outcomes (fatigue) or clinically significant improvements in secondary outcomes (physical function).
Remaining Questions
Do specific types of CAM interventions (rather than CAM use in general) produce different outcomes?
Why do patients continue using CAM despite lack of demonstrated benefit—what are the perceived benefits or mechanisms patients believe are operating?
What This Study Does Not Prove
This study does not prove that specific CAM treatments are ineffective for all ME/CFS patients; it only shows that in this trial sample, CAM use overall was not associated with clinically important improvements in the measured outcomes. The study is observational regarding CAM use and does not include randomized comparison of specific CAM interventions, so causation cannot be established. Results may not generalize to CAM use outside secondary care settings.