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

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.