G C Sutton1. 1. Nuffield Institute for Health, Leeds.
Abstract
BACKGROUND: Myalgic encephalomyelitis (ME) is a mysterious and controversial condition. Debate has centred upon its causation, and the purchasing question-which services to commission for people with ME-has not been addressed. METHODS: A health needs assessment was made of people with ME in Wakefield, based upon published (including grey) literature, and local informants. RESULTS: Previous studies have mostly reflected institutional outbreaks; local needs will reflect community, sporadic cases but there is little information about these. The very wide estimates of prevalence (between zero and 57000 for a district the size of Wakefield) indicate a fundamental problem over the validity of the concept of ME. Four sets of health needs emerged from the literature and from local informants: a medical diagnosis, rest, specific treatments and social care. All four are highly debatable. CONCLUSION: There are no proven services or interventions which the health authority should purchase for people with ME. Purchasing, being a blunt tool for service change, is unlikely to improve health care given the disagreements over the condition.
BACKGROUND:Myalgic encephalomyelitis (ME) is a mysterious and controversial condition. Debate has centred upon its causation, and the purchasing question-which services to commission for people with ME-has not been addressed. METHODS: A health needs assessment was made of people with ME in Wakefield, based upon published (including grey) literature, and local informants. RESULTS: Previous studies have mostly reflected institutional outbreaks; local needs will reflect community, sporadic cases but there is little information about these. The very wide estimates of prevalence (between zero and 57000 for a district the size of Wakefield) indicate a fundamental problem over the validity of the concept of ME. Four sets of health needs emerged from the literature and from local informants: a medical diagnosis, rest, specific treatments and social care. All four are highly debatable. CONCLUSION: There are no proven services or interventions which the health authority should purchase for people with ME. Purchasing, being a blunt tool for service change, is unlikely to improve health care given the disagreements over the condition.
Authors: Maria de Lourdes Drachler; Jose Carlos de Carvalho Leite; Lee Hooper; Chia Swee Hong; Derek Pheby; Luis Nacul; Eliana Lacerda; Peter Campion; Anne Killett; Maggie McArthur; Fiona Poland Journal: BMC Public Health Date: 2009-12-11 Impact factor: 3.295