title: Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome.
abstract: Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue, disability and a range of other symptoms. The PACE trial was randomised to compare four non-pharmacological treatments for patients with CFS in secondary care clinics. The aims of this sub study were to describe the use of complementary and alternative medicine (CAM) in the trial sample and to test whether CAM use correlated with an improved outcome.
  
  
  
  CAM use was recorded at baseline and 52weeks. Logistic and multiple regression models explored relationships between CAM use and both patient characteristics and trial outcomes.
  
  
  
  At baseline, 450/640 (70%) of participants used any sort of CAM; 199/640 (31%) participants were seeing a CAM practitioner and 410/640 (64%) were taking a CAM medication. At 52weeks, those using any CAM fell to 379/589 (64%). Independent predictors of CAM use at baseline were female gender, local ME group membership, prior duration of CFS and treatment preference. At 52weeks, the associated variables were being female, local ME group membership, and not being randomised to the preferred trial arm. There were no significant associations between any CAM use and fatigue at either baseline or 52weeks. CAM use at baseline was associated with a mean (CI) difference of 4.10 (1.28, 6.91; p=0.024) increased SF36 physical function score at 52weeks, which did not reach the threshold for a clinically important difference.
  
  
  
  CAM use is common in patients with CFS. It was not associated with any clinically important trial outcomes.
authors.affiliation: Primary Care and Population Sciences, University of Southampton, UK. Electronic address: gl3@soton.ac.uk.
authors.forename: G
authors.initials: G
authors.lastname: Lewith
authors.affiliation: Primary Care and Population Sciences, University of Southampton, UK.
authors.forename: B
authors.initials: B
authors.lastname: Stuart
authors.affiliation: Academic Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Chalder
authors.affiliation: Primary Care and Population Sciences, University of Southampton, UK.
authors.forename: C
authors.initials: C
authors.lastname: McDermott
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University, London, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: White
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D005081:Exercise Therapy / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D005221:Fatigue / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome
keywords: Alternative medicine; Chronic fatigue syndrome; Complementary medicine