Opinion Is the RACGP HANDI recommendation of incremental physical activity for CFS/ME harming patients?, 2026, Stallard/Praet/Gupta/Smith

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Dolphin

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AJGP > March > Is the RACGP HANDI recommendation of incremental physical activity for chronic fatigue syndrome

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Volume 55, Issue 3, March 2026

Is the RACGP HANDI recommendation of incremental physical activity for chronic fatigue syndrome/myalgic encephalomyelitis harming patients?​

Jacqueline Stallard Stephan Praet Sandeep Gupta Angela Smith
doi: 10.31128/AJGP-03-25-7614 | Download article
In April 2024, The Royal Australian College of General Practitioners (RACGP) Handbook of Non-Drug Interventions (HANDI)committee published a guideline: Incremental physical activity for chronic fatigue syndrome/myalgic encephalomyelitis.1 The HANDI committee claims to recommend interventions that are based on ‘solid evidence’.2 But is this always the case?

Continues at:
www1.racgp.org.au

Is the RACGP HANDI recommendation of incremental physical activity for chronic fatigue syndrome

The Handbook of Non-Drug interventions (HANDI) is an online formulary of non-drug interventions, enabling GPs to offer to a greater choice of interventions to their patients.
www1.racgp.org.au

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Nightsong said:
A response from the "Chair, Editorial Committee for RACGP Handbook of Non-Drug Interventions" in favour of GET:

Invited response to viewpoint article ‘Is the RACGP HANDI recommendation of incremental physical activity for chronic fatigue syndrome/myalgic encephalomyelitis harming patients?’
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Thinks PACE and Larun’s exercise review were good, but says that surveys about harm are at a high risk of bias so we don’t care about those.
The 2023 NICE guideline retraction was highly controversial and not aligned with research evidence, resulting in members of its writing group resigning. Details of the aberrant interpretation of evidence are outlined elsewhere.5,6
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The attention to detail is worrying. It was 2021, and it wasn’t a retraction - it was an update.
 
Are there published data that show that GET is harmful?

I know that there are patient surveys that show this clearly. Are those the best evidence?

Is there any better evidence to point to?

(There probably is a specific thread about this somewhere.)
 
Liie said:
Are there published data that show that GET is harmful?

I know that there are patient surveys that show this clearly. Are those the best evidence?

Is there any better evidence to point to?

(There probably is a specific thread about this somewhere.)
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The PACE trial data? NICE ng206 wrote about it.
 
MrMagoo said:
The PACE trial data? NICE ng206 wrote about it.
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I think I read somewhere that there was a slight but not very significant improvement in the GET and GET+CBT groups.

But there were also patient reports afterwards that therapists didn't take them seriously when they said that they worsened.
 
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