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Abstract

Purpose
Despite a high prevalence of fatigue and its importance to patients, many people with long-term conditions do not receive fatigue management as part of their treatment. This review is aimed to identify clinical guidance for the management of fatigue in long-term physical health conditions.

Methods
A systematic mapping review was conducted in accordance with Social Care Institute for Excellence systematic review guidance. Bibliographic databases and guideline repositories were searched for clinical guidelines for long-term conditions, published between January 2008 and July 2018, with a search for updates conducted in May 2023. Data were extracted on the recommendations made for managing fatigue and, where cited, the underlying research evidence used to support these recommendations was also extracted.

Results
The review included 221 guidelines on 67 different long-term conditions. Only 30 (13.6%) of the guidelines contained recommendations for managing fatigue. These were categorised as clinical (e.g. conduct further investigations), pharmacological, behavioural (e.g. physical activity), psychological, nutritional, complementary, environmental, and multicomponent. The guidelines rated much of the evidence for fatigue management as fairly low quality, highlighting the need to develop and test fatigue-management strategies in high-quality trials.

Conclusion
This review highlights that management of fatigue is a very important neglected area in the clinical guidelines for managing long-term conditions.

Implications for rehabilitation
- Fatigue is a common and debilitating symptom of many long-term physical health conditions; however, many people do not receive treatment for fatigue.
- This mapping review found that very few clinical guidelines contain recommendations for managing fatigue, even where published evidence exists.
- It is essential that developers of clinical guidelines address this important neglected area.

Publication Type:	Article
Additional Information:	© 2024 the author(s). Published by informa UK limited, trading as taylor & Francis Group this is an open access article distributed under the terms of the Creative Commons attribution license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,distribution, and reproduction in any medium, provided the original work is properly cited. the terms on which this article has been published allow the posting of the acceptedManuscript in a repository by the author(s) or with their consent.
Publisher Keywords:	Fatigue; long-term conditions; systematic review; mapping review; clinical guidelines
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:	Symplectic Administrator

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