Chronisch Vermoeidheidssyndroom: diagnose, behandeling en ...

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102 Chronic Fatigue Syndrome KCE reports 88 Table 13. Comparison of CFS care for adults in selected countries ADULTS United Kingdom: England The Netherlands Italy Norway Australia Belgium Specific settings Yes: 13 coordinating Yes: 2 university Yes: 4 centres Yes: 2 university No Yes: 4 reference centres CSF/ME centres or CNCCs; 36 hospitals (16.4 million diagnosis and hospitals (4.7 million (10.5 million inhabitants) local multidisciplinary inhabitants) therapy, 3 centres inhabitants) teams or LMDTs diagnosis (57 million (covering 32.5 million people; i.e. 65% of 50 million inhabitants of England) inhabitants) Level of specific Third and second level Third level; networking Third and second Third level. Under N.A. Third level; networking settings (coordinating centres and with secondary level level development in one with community care local multidisciplinary centres (Centres for centre (Project, start planned but not teams); networking with Mental Health Care or 8/2008): networking developed yet local hospitals and GGZ) to provide care with local hospitals and community care to locally when possible/ community care to provide care locally when appropriate provide care locally possible/ appropriate when possible/ appropriate Settings recognized Yes (since 2004) No (however, No information Yes (since 2007) N.A. Yes (since 2002) by Government networking with secondary level is supported by Government) Other diagnoses than No Yes: fatigue related to Yes: fatigue related No N.A. No CFS included severe medical to severe medical conditions (e.g. cancer) conditions (e.g. cancer); fibromyalgia Referral by medical doctor necessary Yes Yes for one centre No Yes N.A. Yes Yearly diagnostic plus 17/100 000 (numbers No information 1/100 000 (50% new 16/100 000 (75% new N.A. 5/100 000; 96% therapeutic capacity based on Government patients) (numbers patients; 66% confirmed confirmed CFS diagnosis of all report) based on expert CFS diagnosis (numbers (numbers based on settings/100 000 estimation only) based on expert Government report) inhabitants estimation only) Waiting lists Yes; but Government Yes No Yes (9-12 months) N.A. Yes (in 3 of 4 centres)
KCE Reports 88 Chronic Fatigue Syndrome 103 ADULTS United Kingdom: England imposes “18 week pathway”: assessment within 5 weeks, referral to treatment time should not exceed 18 weeks Diagnosis Online support of referring M.D. to make diagnosis, blood samples as in NICE guideline. Special referral forms. If necessary further explored by CFS centre or referral to medical specialist of network when no M.D. part of the CFS team. Predominant Several options; recently treatment content general evolution toward (other than CBT (some centres medication if needed) exclusively CBT, GET or (in trial) pacing) Treatment manual (CBT or GET) in one or more centres available Usual treatment (based on expert information only, except Belgium): individually or group / in- or outpatient Yes (CBT), efficacy approved in research applications Group sessions most used, but individual therapy possible; some large centres exclusively individual therapy / outpatient usually but 8 national CFS beds and The Netherlands Italy Norway Australia Belgium Online support of referring M.D. to make diagnosis, if necessary further explored by CFS centre. Special referral form. One centre specific medical treatments. Other centre CBT, it does not accept patients as long as involved in other therapy for fatigue or gone to court Yes (CBT), efficacy approved in research applications Individual treatment only/ mostly outpatient By the CFS centre By medical specialist (belonging or not to the CFS centre) General psychotherapy Coping classes with several components; recently beginning evolution toward GET (or CBT), in coping classes N.A. Special referral form. Diagnosis confirmed or if necessary further explored by CFS centre N.A. CBT and GET together No No N.A. Manual in each centre; efficacy not approved in research applications Individual treatment only/ mostly outpatient but one centre specialized inpatient service Group sessions (coping classes) most used; individual therapy rarely/ mostly outpatient but one centre with specialized inpatient service to start in nearby N.A. Group sessions in 83% of time and individual therapy in 17% of time; outpatient mostly; inpatient possible but rarely (based on Government report)
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