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22: Improved evaluation and treatment outcome for chronic fatigue syndrome

Summary of the impact

Chronic fatigue syndrome (CFS) is characterised by prolonged and profound fatigue. The prevalence of CFS is between 0.2% and 2.6% worldwide. Researchers from King's College London (KCL) have shown that Cognitive Behaviour Therapy and Graded Exercise Therapy can improve the symptoms and disability of CFS. This evidence led to both therapies being recommended by the National Institute for Health and Care Excellence and the British Association for Chronic Fatigue Syndrome/ME and becoming standard practice in the UK. These treatments, backed by the KCL studies, are also recommended worldwide including in the United States, Australia and Norway.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

Sleepio, an online course of cognitive behavioural therapy for insomnia adopted by the UK NHS and sold by Boots UK Plc.

Summary of the impact

Around 28% of people worldwide will experience a sleep disorder at some point in their lives. Cognitive behavioural therapy (CBT) is an optimal treatment of choice for sleep disorders, but access to treatment is limited by the low number of expert CBT practitioners, resulting in long waiting times for CBT. University of Glasgow Sleep Centre research led to the development of an online CBT course (`Sleepio'), which has been sold online since 2010, and since September 2012 has been sold online by The Boots Company Plc. (Boots). Sleepio has been included in the NHS Health Apps Library and selected for integration with two of the best-selling fitness monitors. University of Glasgow expertise also underpinned `Sleep Matters', a year-long campaign by the UK Mental Health Foundation (MHF) which generated 300 media articles with a combined circulation of 145 million, raising awareness of and widening access to treatment for sleep disorders.

Submitting Institution

University of Glasgow

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

UOA04-05: Development and Demonstration of the First Effective Therapy for Chronic Fatigue Syndrome

Summary of the impact

Chronic Fatigue Syndrome or CFS (also known as CFS/ME) affects two percent of the population. Michael Sharpe and colleagues in Oxford developed a cognitive behavioural treatment (CBT) for CFS. In 1996 they published the first randomised controlled trial finding that CBT was substantially more effective than standard care, with patients three times more likely to improve. This was the first treatment ever to be shown to be effective for CFS in a clinical trial. The finding was subsequently confirmed in other trials. Sharpe's research has benefitted people with CFS by: [a] challenging the prevailing view of the illness as untreatable, [b] informing current NICE treatment guidance, [c] providing the leading evidence-based treatment. In England alone, the treatment is implemented in 46 NHS specialist CFS centres, to over 7000 patients per year.

Submitting Institution

University of Oxford

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Improving the uptake of Occupational Therapy as an evidenced-based intervention to improve management of Chronic Fatigue Syndrome

Summary of the impact

The work of Professor Diane Cox has been instrumental in enhancing services and improving outcomes for patients with Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME), and other fatigue related conditions. Primarily, this has been through changing the interventions used by Occupational Therapists and other Allied Health Professionals in healthcare practice to manage such conditions. The research has influenced amendments to professional standards, guidelines and training for use of activity and lifestyle management approaches to treating CFS and related conditions, and has had further impact through influencing the set-up of specific CFS services using these techniques. The research has demonstrated that Occupational Therapy can improve engagement and participation in occupations through activity, and led to its widespread uptake into practice throughout the UK. The research has underpinned the National Institute for Health and Clinical Excellence (NICE) guidelines for CFS/ME and directly influenced the form and implementation of NHS and private service provision for these conditions in the UK.

Submitting Institution

University of Cumbria

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

10: Early effective treatment of bulimic eating disorders through self-care interventions

Summary of the impact

Bulimic eating disorders are disabling conditions affecting approximately 5% of the population. Effective specialist treatment exists in the form of cognitive behavioural therapy (CBT), but only a minority of patients access this. Researchers at King's College London developed book-, CD-ROM-and web-based CBT self-care interventions for bulimic disorders that provide early effective treatment with outcomes comparable to costly specialist CBT. Locally, at the South London and Maudsley NHS Foundation Trust Eating Disorders Service, this has significantly reduced waiting lists. The research has had national and international impact with UK, German and US guidelines endorsing guided self-care as a first treatment step for bulimic disorders and the KCL manual and website are internationally recommended.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

F: Medically unexplained symptoms including chronic fatigue syndrome can be accurately identified and treated.

Summary of the impact

Impact: By showing the benefits of accurate identification and targeted treatment of chronic fatigue syndrome, UoE research has influenced worldwide medical practice and stimulated public and governmental debate.

Significance: Guidelines and policy debate have resulted in improved patient treatment, with associated economic benefit.

Beneficiaries: Patients with medically unexplained symptoms, policy-makers, clinicians.

Attribution: Work conducted at UoE in a team led by Carson and Sharpe.

Reach: The research affects the more than 25% of all GP presentations who have unexplained symptoms / chronic fatigue syndrome (40% in gastroenterology and neurology). Guidelines have been changed internationally including UK, USA, Australasia.

Submitting Institution

University of Edinburgh

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences

Transforming Treatment for Balance Disorders: Booklet-Based Balance Retraining

Summary of the impact

A decade of research at the University of Southampton has given thousands of people around the world suffering from dizziness and balance disorders access to a self-management resource that can alleviate their symptoms. Professor Lucy Yardley has pioneered the use of a Balance Retraining (BR) booklet to transform the means of delivering cost-effective, life-changing treatment previously offered to less than one in ten UK patients. The booklet, translated into several languages, has been distributed to patients and practitioners as far afield as China and Japan. Yardley's findings have contributed the bulk of good quality evidence to the Cochrane Review on vestibular rehabilitation.

Submitting Institution

University of Southampton

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Nursing, Public Health and Health Services

Improving the primary care management of insomnia

Summary of the impact

Research into primary care insomnia by the Community and Health Research Unit (CaHRU) has led to broad improvements in healthcare provision for insomnia, improved patient quality of life, informed national/international policy and practice in insomnia care and impacted directly on health professional practice and insomnia sufferers, initially in Lincolnshire spreading across the UK and internationally from 2008 to 2011. Direct effects on practice include changes in sleep management and reduced hypnotic prescribing through seminars, workshops, conferences and e-learning developed by the team; inclusion in UK policy, practitioner information, training materials and guidance on hypnotics has led to greater professional and public awareness of sleep management internationally.

Submitting Institution

University of Lincoln

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

Mood Disorders Centre – Improving Psychological Treatments for Depression

Summary of the impact

Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.

Submitting Institution

University of Exeter

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Improving access to self-help therapies for mental health

Summary of the impact

An estimated one in four people in the UK will experience depression or anxiety at some point in their lives. Cognitive behavioural therapy (CBT) is the most widely recommended non-medication- based treatment for common mental health problems, although access to this treatment is limited because of low numbers of expert practitioners. Self-help CBT resources developed by researchers at the University of Glasgow have been integrated into routine clinical practice delivered by health services and the voluntary sector in the UK, Ireland and Canada. Since 2008, these practical user-friendly resources have provided support to over 200,000 users online and an estimated 250,000 people on a one-to-one basis or within a class.

Submitting Institution

University of Glasgow

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

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