Researchers from London studied 222 patients reporting fatigue for over three months. They were given either ‘usual care’ – providing a booklet describing causes of fatigue and self-help techniques based on cognitive behavioural therapy – or NICE-approved therapies such as counselling and graded exercise.
They found fatigue symptoms in patients treated with graded exercise therapy or counselling were no better during this time than those who had been managed with usual care.
There was an improvement in the Chalder fatigue score over time regardless of which treatment group patients were in. The improvement between six month and 12 month follow-up was not significantly different between those receiving usual care and those receiving either graded exercise therapy or counselling.
In general, dissatisfaction with care was high. But there was no significant difference between the three groups at six months. However, there was a difference in dissatisfaction between groups at 12 months, with those in the booklet group being more dissatisfied.
Study lead, Professor Leone Ridsdale, professor of neurology and general practice at King’s College London,said: ‘Our findings suggest that many patients improve substantially in the first six months.’
‘From the current evidence, we propose that after assessment of patients who present with fatigue in primary care, doctors offer to reassess them in six months. If fatigue symptoms persist, the practitioner and patient may discuss further therapy options.’
Wait 6 months before treating fatigue
