Which interventions are acceptable to patients for managing fatigue in long-term conditions?: A qualitative evidence synthesis,2025,Booth/Deary/Burton

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Dolphin

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Review Article

Which interventions are acceptable to patients for managing fatigue in long-term conditions?: A qualitative evidence synthesis​

Andrew Booth
,
Gill Rooney
,
Anthea Sutton
,
Jo Leaviss
,
Vincent Deary
,
Helen Dawes
&
Chris Burton
show less
Received 11 Apr 2025, Accepted 17 Nov 2025, Published online: 08 Dec 2025

Abstract

Purpose​

This qualitative evidence synthesis examined patient experiences of fatigue interventions among adults with diverse long-term conditions, complementing the EIFFEL systematic review and meta-analysis of intervention effectiveness.

Materials and Methods​

A comprehensive search across MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Scopus identified relevant studies. Data underwent inductive thematic analysis followed by deductive coding using AI-generated thematic summaries (Claude 3.7 Sonnet), which were verified by an experienced reviewer.

Results​

The review identified 40 papers (36 papers from the original search plus four from an October 2025 update) covering 35 studies within six transdiagnostic themes: Coherence/Understanding, Process of Change, Personalisation/Applicability, Barriers to Engagement, Social Support, and Delivery Format. These themes applied across both common interventions used for different conditions and condition-specific approaches. Personalisation and tailoring emerged as essential throughout. Notably, within-condition differences proved as significant to patient experience as between-condition comparisons.

Conclusions​

This transdiagnostic synthesis reveals shared patient needs across conditions. Acceptable interventions provide coherent explanations, balance structure with flexibility, and address knowledge, expectations, and behaviours without imposing additional burden. Future interventions should integrate transdiagnostic insights and personalisation opportunities to address fatigue complexity.

IMPLICATIONS FOR REHABILITATION​

  • Transdiagnostic approaches to fatigue management may be beneficial, as the experience of fatigue appears to share commonalities across various long-term conditions regardless of specific diagnoses.
  • Personalisation and tailoring of fatigue interventions is essential, as within-condition differences can be as important as between-condition comparisons.
  • Rehabilitation programs should address the need for coherence and understanding of fatigue as part of the process of patient engagement and change.
  • Social support elements should be incorporated into fatigue management strategies, as this need was identified for both individual and group-based interventions.
  • Consideration of delivery format is important for effective implementation of fatigue interventions across different long-term conditions.
Keywords:

 
Acceptable interventions provide coherent explanations,​

What about accurate? Does that have any relevance and importance?

without imposing additional burden.​

Have you ever considered not burdening us with endless psycho-moral speculation, and just generally getting off our backs?

Anything with Dreary and Burton's names on it is suspect, IMHO. They are not friends to ME/CFS patients.
 
Inclusion criteria were identified in a two-stage process. The review targeted adults with any long-term condition, using the NHS definition as “an illness that cannot be cured but that can usually be controlled with medicines or other treatments”. The commissioning brief specifically excluded fatigue in people with cancer, in relation to or following from infection (HIV, Hepatitis C, Long Covid and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) or resulting from injuries or developmental disorders. It also excluded conditions in which symptoms, rather than observable pathology, were the defining features (e.g. fibromyalgia or irritable bowel syndrome).
Click to expand...

But it will probably be cited as relevant to these conditions anyway...
 
The 'Thematic Analysis' offers a series of quotes from patients describing how they had blamed themselves for being lazy or weak when they were fatigued, but once they learned about fatigue as a consequence of stroke or kidney disease, etc., they coped better with it. The researchers' interpretation of this is that a biomedical understanding of fatigue is bad and a 'biopsychosocial' understanding is better. :emoji_shrug:
 
Why are they asking about what patients like instead of what’s effective?

Surely it would be better to first identify the effective interventions, then looking at uptake, and then looking at barriers to uptake if that’s an issue?

They wouldn’t get further than the first question, but at least we’d have saved the resources used to produce this meaningless publication.
 
This is the product of decades of wasteful nonsense. This is the very best they have to show for it. Absolutely nothing. They can't even ask relevant questions. What is acceptable is entirely irrelevant, everything stems from effectiveness, and nothing produced within the medical profession about this issue is, so acceptability is completely pointless. It's like deciding which pants someone should wear on their head.

Obviously this has nothing to do with rehabilitation, since it has not produced a single useful bit of information on the issue, so the authors bring it for their own self-serving reasons having nothing to do with actual needs. The Vatican does better astronomy than these people do anything resembling actual health care. Everything they talk about is entirely about them, about what they want and prefer. They completely ignore the patient perspective and needs, and this is why they don't know a single thing more than freaking Hippocrates' neighbour did.

This stuff should be mortally embarrassing. Showing this is completely disqualifying in a "I did this presentation 10 minutes before showing up here, drunk and frankly totally bored about it". In most professions it would get them booed off stage and dismissed as cranks.
 
Utsikt said:
Why are they asking about what patients like instead of what’s effective?

Surely it would be better to first identify the effective interventions, then looking at uptake, and then looking at barriers to uptake if that’s an issue?

They wouldn’t get further than the first question, but at least we’d have saved the resources used to produce this meaningless publication.
Click to expand...
Well now they have yet another useless publication on their influencer rating and isn't that really all that matters here?

It clearly is.
 
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