Fatigue in Patients with Rheumatic and Musculoskeletal Diseases: a Scoping Review on Definitions, Measurement Instruments, Determinants, Consequences and Interventions

Overview

Journal RMD Open

Publisher BMJ Publishing Group

Specialty Rheumatology

Date 2023 Aug 4

PMID 37541741

Authors

Esther Beckers

Kasper Hermans

Astrid van Tubergen

Annelies Boonen

Affiliations

Soon will be listed here.

Abstract

Objectives: To scope published reviews addressing fatigue in rheumatoid arthritis (RA), spondyloarthritis, osteoarthritis and fibromyalgia in areas relevant for clinical practice: (1) definition, (2) measurement instruments and diagnosis, (3) determinants, (4) consequences and (5) effectiveness of interventions.

Methods: A systematic literature search of reviews was performed in five bibliographical databases. A hierarchical data extraction was applied based on review type (Cochrane reviews (CRs), followed by non-Cochrane systematic reviews (SRs) and narrative reviews (NRs)) and year of publication. Extracted data were summarised in elaborated narrative syntheses. Results were discussed with a patient panel.

Results: One hundred and thirty-four reviews were included (19 CRs, 44 SRs, 71 NRs). No agreed on definition was reported for general fatigue, nor for types of fatigue. Twenty-five measurement instruments were found, all self-reported. Five instruments proposed a threshold for excessive fatigue. Pain, physical function and depressive symptoms were the most frequently studied disease-related determinants of fatigue; female sex and stress the most frequent contextual determinants. Work performance, followed by impact on pain, physical activity and social roles were the most frequently studied consequences. Whenever quantified, associations between fatigue with determinants and consequences were on average small. For non-pharmacological interventions, if effect sizes were reported, these were negligible to small and for pharmacological interventions negligible to moderate. Patients recommended actions for research and practice.

Conclusion: Syntheses of reviews point to the complexity of fatigue. The extensive amount of evidence could be used to offer tailored management plans to patients in clinical practice and inform future research agendas.

Citing Articles

The potential role of fatigue in difficult-to-treat rheumatoid arthritis.

Leon L, Freites-Nunez D, Madrid A, Rodriguez-Mariblanca M, Fernandez-Gutierrez B, Abasolo L BMC Rheumatol. 2024; 8(1):49.

PMID: 39350299 PMC: 11440696. DOI: 10.1186/s41927-024-00423-5.

Assessing fatigue in women over 50 years with rheumatoid arthritis: a comprehensive case-control study using the FACIT-F scale.

Valencia-Muntala L, Gomez-Vaquero C, Berbel-Arcobe L, Benavent D, Vidal-Montal P, Juanola X Front Med (Lausanne). 2024; 11:1418995.

PMID: 39118668 PMC: 11306178. DOI: 10.3389/fmed.2024.1418995.

Connecting the dots: the role of fatigue in female infertility.

Li W, Huang X, Wei Y, Yin T, Diao L Reprod Biol Endocrinol. 2024; 22(1):66.

PMID: 38849828 PMC: 11157719. DOI: 10.1186/s12958-024-01235-5.

Factors influencing the outcomes of non-pharmacological interventions for managing fatigue across the lifespan of people living with musculoskeletal (MSK) conditions: a scoping review protocol.

Fishpool K, Young G, Ciurtin C, Cramp F, Erhieyovwe E, Farisogullari B BMJ Open. 2024; 14(5):e082555.

PMID: 38702081 PMC: 11086445. DOI: 10.1136/bmjopen-2023-082555.

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