What are the recommended management strategies for chronic fatigue syndrome in primary care?

Manage any underlying causes and contributory factors as identified on initial assessment ¹.

Offer advice on sources of information and support, including providing an understandable explanation of CFS, its fluctuating nature, and the importance of self-management strategies ¹.

Discuss with people with ME/CFS the principles of energy management, emphasizing that it is not curative, involves self-management, and includes all types of activity, helping to reduce post-exertional malaise ².

Help develop a tailored energy management plan covering cognitive, physical, emotional, and social activities, sleep, rest, and environmental factors, with ongoing review and adjustment ².

Offer cognitive behavioural therapy (CBT) to help manage symptoms, improve functioning, and develop self-management strategies, with regular review and adaptation ².

Arrange a review of care and support at least once a year, including assessment of symptom changes, energy management, physical activity, psychological wellbeing, and future planning ¹.

Refer to specialist teams if symptoms persist beyond 3 months, are unexplained, or if there is significant uncertainty, especially for complex cases or when considering secondary care ¹.