Testing the efficacy of web-based cognitive behavioural therapy for adult patients with chronic fatigue syndrome (CBIT): study protocol for a randomized controlled trial.
BACKGROUND
Cognitive behavioural therapy (CBT) is an effective treatment for fatigue and disabilities in patients with chronic fatigue syndrome (CFS). However, treatment capacity is limited. Providing web-based CBT and tailoring the amount of contact with the therapist to the individual needs of the patient may increase the efficiency of the intervention. Web-based CBT for adolescents with CFS has proven to be effective in reducing fatigue and increasing school attendance. In the proposed study the efficacy of a web-based CBT intervention for adult patients with CFS will be explored. Two different formats of web-based CBT will be tested. In the first format named protocol driven feedback, patients report on their progress and receive feedback from a therapist according to a preset schedule. In the second format named support on demand, feedback and support of the therapist is only given when patients ask for it. The primary objective of the study is to determine the efficacy of a web-based CBT intervention on fatigue severity.


METHODS
A randomized clinical trial will be conducted. Two-hundred-forty adults who have been diagnosed with CFS according to the US Centers for Disease Control and Prevention (CDC) consensus criteria will be recruited and randomized to one of three conditions: web-based CBT with protocol driven feedback, web-based CBT with support on demand, or wait list. Feedback will be delivered by therapists specialized in CBT for CFS. Each of the web-based CBT interventions will be compared to a wait list condition with respect to its effect on the primary outcome measure; fatigue severity. Secondary outcome measures are level of disability, physical functioning, psychological distress, and the proportion of patients with clinical significant improvement in fatigue severity. Outcomes will be assessed at baseline and six months post randomization. The web-based CBT formats will be compared with respect to the time therapists need to deliver the intervention.


CONCLUSIONS
As far as we know this is the first randomized controlled trial (RCT) that evaluates the efficacy of a web-based CBT intervention for adult patients with CFS.


BACKGROUND
NTR4013.
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Anthonie.Janse@radboudumc.nl.
Anthonie
A
Janse
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Margreet.Worm-Smeitink@radboudumc.nl.
Margreet
M
Worm-Smeitink
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Jose.Bussel-Lagerde@radboudumc.nl.
José
J
Bussel-Lagarde
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Gijs.Bleijenberg@radboudumc.nl.
Gijs
G
Bleijenberg
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Stephanie.Nikolaus@radboudumc.nl.
Stephanie
S
Nikolaus
Expert Centre for Chronic Fatigue, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Hans.Knoop@radboudumc.nl.
Hans
H
Knoop
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006233:Persons with Disabilities; D005221:Fatigue / Q000628:therapy; D015673:Fatigue Syndrome, Chronic / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D020407:Internet; D008875:Middle Aged; D012107:Research Design; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists; D055815:Young Adult