Review Multimodal treatment strategies for homebound people with severe ME/CFS: a scoping review 2024 Mayer-Huber et al

[Note: All auto-translated from original German by Google]

Objective: This scoping review aims to provide an overview of previously published treatment strategies that are multimodal and not purely drug-based and are suitable for home- or bed-bound ME/CFS patients. The focus is therefore on the analysis of telemedicine and outreach treatment elements. In addition, the evaluation and analysis methods used in the studies considered are highlighted.

Method: After a literature search according to the scoping review method and using predefined criteria, 14 publications were included and evaluated. The prerequisite for inclusion were models that are applicable to housebound people with ME/CFS and refer to social-medical and psychological support services and not to individual medication strategies.

Result: The treatments assessed as suitable predominantly took place in an outreach (home visit) (n=5) or telemedicine (n=7) format. Studies with a different setting were included because the model described could be converted into a telemedicine concept. In addition, in several studies (n=8), individualization and flexibility of the treatment method - and thus the possibility of being able to address the current extent of the impairment - were also identified as important factors in dealing with this patient group. Six studies described additional, explicit involvement of families in the treatment concept. Ten articles described the evaluation of a treatment concept, mostly using questionnaires (n=7). No consistent use of specific questionnaires was identified. Qualitative evaluations were consistently carried out using thematic analysis according to Braun and Clarke (n=3).

Conclusion: The total number of publications dealing with multimodal treatment strategies for homebound ME/CFS patients is low. However, outreach and telemedicine approaches can be found. The majority of the publications identified address the need for individualized, flexible care. Some dedicate themselves to the potential additional gain through explicit involvement of relatives. The researched data demonstrate the special challenges in the care of severely affected ME/CFS patients and imply that these special features must also be taken into account in the research context.

Purpose: This scoping review aims to provide an overview of previously published treatment strategies that are multimodal, rather than purely drug-based and may be considered for home- or bedbound ME/CFS patients. Thus, the focus lies upon the analyzes of telemedicine as well as home treatment elements. In addition, the evaluation and assessment methods used in these studies will be further discussed.

Methods:Using the scoping review method, a literature analysis was conducted resulting in a total of 14 publications which met the predefined criteria. Inclusion was based on models applicable to housebound individuals with ME/CFS, focusing on social medicine and psychological support services rather than individual drug strategies.

Results: The analysis demonstrated that the appropriate treatment methods were predominantly home visits (n=5) or a telemedicine format (n=7). Studies which used alternative settings were included if conversion to a telemedicine format was viable. The important factors highlighted in several studies (n=8), when considering this patient group, were individualization and flexibility of the treatment methods - and thus the ability to address the day-to-day levels of impairment. The explicit involvement of families in the treatment plan was described in a total of six studies. In ten articles, the treatment concept was additionally evaluated, predominantly using questionnaires (n=7), whilst the questionnaires used were not consistent. Qualitative evaluations were invariably conducted using Brown and Clarke's thematic analysis (n=3).

Conclusion: Publications on multimodal treatment strategies for homebound ME/CFS patients are rare. However approaches using home visits or telemedicine are described. The majority of identified publications addressed the need for individualized as well as flexible patient care, whilst some were dedicated to the added value of involving the patients' family. The data outlines the specific challenges associated with the care of severely affected ME/CFS patients that should also be considered in the context of research.However approaches using home visits or telemedicine are described. The majority of identified publications addressed the need for individualized as well as flexible patient care, whilst some were dedicated to the added value of involving the patients' family. The data outlines the specific challenges associated with the care of severely affected ME/CFS patients that should also be considered in the context of research.However approaches using home visits or telemedicine are described. The majority of identified publications addressed the need for individualized as well as flexible patient care, whilst some were dedicated to the added value of involving the patients' family. The data outlines the specific challenges associated with the care of severely affected ME/CFS patients that should also be considered in the context of research.

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Looks like it has sequential German and English abstracts, hence the duplication. (Unsurprisingly it's a 2/3:1/3 text ratio !)