Defining routine fatigue care in Multiple Sclerosis in the United Kingdom: What treatments are offered and who gets them?

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> Fatigue is common and disabling in Multiple Sclerosis (MS). A recent meta-analytic systematic review reported 113 trials of exercise and behavioural interventions for fatigue, yet patients consistently describe fatigue being under-treated. The extent of the research-to-practice gap is yet to be documented. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> To describe what fatigue treatments people with MS (pwMS) in the United Kingdom (UK) have been offered. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A cross-sectional survey of pwMS on the UK MS Register (UKMSR). Data on fatigue treatments offered were collected using an online questionnaire developed with patient input and summarised using descriptive statistics. Sociodemographic, MS-related, and psychological factors associated with treatment offered were evaluated using a logistic regression model. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> 4,367 respondents completed the survey, 90.3% reported experiencing fatigue. Of these, 30.8% reported having been offered at least one type of pharmacological/non-pharmacological treatment for fatigue. Pharmacological treatments were more commonly offered (22.4%) compared to non-pharmacological treatments (12.6%; 2.9% exercise and 5.9% behavioural therapy). In the logistic regression model, older age, working, shorter time since MS diagnosis, and lower fatigue were associated with lower odds of having been offered treatment for fatigue. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> This study accentuates the extent of the unmet need for fatigue treatment in MS in the UK. </jats:p></jats:sec>