Abstract
Background: Fatigue is a common and debilitating symptom for people living with multiple sclerosis (MS). The evidence suggests that behavioural treatments, particularly cognitive behavioural therapy and some exercise therapies, are effective in reducing MS fatigue. However, few people are offered these treatments in routine care, and little is known about the reasons for this research-to-practice gap. The aim of this study was to explore how routine care is currently delivered for MS fatigue.
Methods: Healthcare professionals (n=28) took part in six focus groups and six one-to-one interviews exploring experiences with assessing, managing and treating fatigue. How healthcare professionals (n=10) delivered MS fatigue management was observed across 19 patient-clinician consultations in four NHS services in London, the North East, and South West of England. All data were analysed using reflexive thematic analysis.
Results: Three key themes with subthemes were generated: a) ‘MS fatigue is not formally screened’, b) ‘Selling self-management for MS fatigue’, and c) ‘MS fatigue cannot be treated in isolation’. Key findings included the reliance on people living with MS to recognise and acknowledge their experience of fatigue, the use of the multi-disciplinary team to drip-feed fatigue management, and the tendency for professionals to sometimes differ in their interpretation of fatigue management advice.
Conclusions: The findings indicate that introducing a formal screening measure and developing a standardised, evidence-based behavioural treatment that is implementable in routine care may allow for improved treatment provision for MS fatigue.
Methods: Healthcare professionals (n=28) took part in six focus groups and six one-to-one interviews exploring experiences with assessing, managing and treating fatigue. How healthcare professionals (n=10) delivered MS fatigue management was observed across 19 patient-clinician consultations in four NHS services in London, the North East, and South West of England. All data were analysed using reflexive thematic analysis.
Results: Three key themes with subthemes were generated: a) ‘MS fatigue is not formally screened’, b) ‘Selling self-management for MS fatigue’, and c) ‘MS fatigue cannot be treated in isolation’. Key findings included the reliance on people living with MS to recognise and acknowledge their experience of fatigue, the use of the multi-disciplinary team to drip-feed fatigue management, and the tendency for professionals to sometimes differ in their interpretation of fatigue management advice.
Conclusions: The findings indicate that introducing a formal screening measure and developing a standardised, evidence-based behavioural treatment that is implementable in routine care may allow for improved treatment provision for MS fatigue.
| Original language | English |
|---|---|
| Journal | International Journal of MS Care |
| Publication status | Accepted/In press - 23 Jun 2025 |
Keywords
- multiple sclerosis
- fatigue
- routine care
- exercise
- cognitive behavioural therapy
- thematic analysis