The Danish Health Authority rejects patients' experience: 'It's simply not right'
Disabled, depressed and failed in the healthcare system - patients with the disease ME have come forward in a large number of articles on bt.dk, but according to them, no one listens.
Marie Louise Ilsøe Gustavussen lies in her bed 24 hours a day. She consumes blended food and has lost her youth to the disease.
21-year-old Nanna Viffeldt Smistrup has a good day if she can drink a coffee with her mother - but then she also has to lie down for the rest of the day.
Before Pia Krabbe Larsson got ME, she was a home nurse and ran around with her two boys. Today she can walk a few steps and needs seven rests a day.
ME has taken the joys of life from Eline Klitgaard. The disease has forced her into solitude, where she needs help for everything.
Both Marie Louise Ilsøe Gustavussen, Nanna Viffeldt Smistrup, Pia Krabbe Larsson, Eline Klitgaard and approximately 100 ME patients and relatives, who B.T. have been in contact with, have all been made worse by being treated in the Danish healthcare system based on the recommendations of the Danish Health Authority.
They have been diagnosed with ME, which is a serious, chronic disease that affects the nervous, immune and hormonal systems.
In Denmark, the National Board of Health recommends graduated training and cognitive behavioral therapy as part of the treatment for patients with ME/CFS at centers for functional disorders based on a collection of scientific articles and studies, they state.
A treatment that has bedridden a large number of patients.
"It is difficult to maintain hope when health authorities in Denmark stubbornly maintain that ME is a functional disorder, where you can think and train healthy. It is a mystery to me that they refuse to listen to the patients, who, after all, live with the disease every single day,' said Marie Louise Gustavussen to B.T. last Friday.
In response to a previous criticism, the Danish Health Authority has stated to B.T. that they base a large part of their knowledge base for the current recommendations on a Cochrane review that recommends graded training and cognitive behavioral therapy.
But B.T. have examined the Cochrane review. They themselves have stated that their studies are based on outdated research - and may be a danger to the patient, which is why it must be completely reassessed.
Exactly what patients and professionals have been clamoring for for years.
In 2021, the British National Institute of Health's new research in the area was published in a NICE report, which points to the same thing: the Danish recommendations for the treatment of ME can make the patient worse.
B.T. The deputy director of the Danish Health Authority, Helena Probst, has leveled the criticism.
How much do you base your knowledge base for the current recommendations on the Cochrane review?
"Reviews and recommendations will have to be continuously updated when new information becomes available. This is an area where, unfortunately, incomplete knowledge and focus is still lacking. Over recent years, we have set up specialized services in all regions - and their task is both to build knowledge, follow the latest research in the field and take care of seriously ill patients.'
But the latest knowledge and research in the field are the new NICE guidelines from 2021. You have said several times that you will not adjust your recommendations based on them - and at the same time you say that the health professionals are precisely obliged to follow them latest knowledge?
"The research in the area, on which the guidelines are also based, is not necessarily of the highest quality. It is not at all uncommon for researchers and health professionals to have professional discussions to develop the field. At the same time, we must help the patients. We start from the best knowledge we have."
But what is the best knowledge if it is not the latest research in the field?
"It is the total knowledge we have and what is in relation to the Cochrane review. It is important to make it very clear that you must start from professional knowledge, but you must also always listen to the patient's experiences and start from what the patient experiences as benefiting.'
B.T. has spoken to more than 100 ME patients and several professionals. They unanimously say that the National Board of Health's recommendations worsen the patient's condition?
"It's simply not right. It is simply setting up a completely false premise. For several years, we have been very focused on helping this group of patients better, and have long pointed to a great need for a strengthened national focus. When you talk about graduated training, it is not the case that you have to have a training program. It is about gradually helping the individual to achieve a better functional level with adapted increased activity.
There are just too many examples of patients who have gotten worse after being treated based on your recommendations. Several patients were admitted bedridden after a trip in the Danish healthcare system, because they were pressured into, for example, graduated training?
"I fully acknowledge that there are some patients who have been met with stigmatization and mistrust, and there are patients we have not helped well enough at all. Unfortunately, there is no perfect treatment today, but it is important for me to emphasize that many people can actually get much better, and some can recover completely. We have a great obligation to make it better.'
You also say that there are specialized offers, but it is not specialized for ME patients, is it?
"Yes, they (centres for functional disorders, ed.) see patients with both chronic fatigue, ME and functional disorders."
The criticism is precisely that ME is not separated from functional disorders in Denmark - and that the same treatment that is for chronic fatigue, for example, worsens ME patients?
"We must do everything to help sick patients, and we have built a completely unique framework in Denmark to ensure continuous development in this area. We have a very good professional, organizational and research foundation, and we must develop this in dialogue with professionals, domestic researchers and the patients.'
But ME patients are still not separated from functional disorders, as patients, professionals, neighboring countries and a unanimous parliament already demanded in 2019?
"Yes, there are different diagnosis codes, but no, the treatment does not differ."