ePrints

Effectiveness of non-pharmacological interventions for fatigue in adults with long-term conditions: a synopsis of the EIFFEL mixed-methods evidence synthesis

Lookup NU author(s): Emerita Professor Julia Newton

Downloads

• Published version [.pdf]

Licence

This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2026, NIHR Journals Library. All rights reserved.Background: Fatigue is common in many long-term medical conditions. Interventions to date have largely been in single conditions. Objective: To conduct a mixed-methods evidence synthesis of the clinical and cost-effectiveness and acceptability of non-pharmacological interventions for fatigue in adults with long-term medical conditions. Methods: Eligibility criteria: Randomised controlled trials, cost-effectiveness studies, or qualitative studies of non-pharmacological interventions for fatigue in long-term medical conditions where fatigue was either a criterion for inclusion, the primary target of the intervention, or the primary or coprimary outcome. Studies of post-infectious, post-traumatic, cancer-related or idiopathic fatigue were excluded. Information sources: Searches used the MEDical Literature Analysis and Retrieval System, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association PsycInfo® (American Psychological Association, Washington, DC, USA) databases. We used systematic CLUSTER searching for qualitative studies and Epistemonikos for systematic reviews. Involvement of patients: We held three rounds of five focus groups involving people with fatigue in long-term conditions to ensure that assumptions in, and reporting of, the research had validity with the patient population. Risk of bias: Risk-of-bias assessment of all studies included in the network meta-analysis was undertaken using an adapted version 2 of the Cochrane risk-of-bias tool for randomised controlled trials. Synthesis of results: Clinical effectiveness evaluation used random effects network meta-analyses at three time points. The cost-effectiveness analysis involved a de novo analysis of interventions identified as clinically effective. The qualitative synthesis involved a thematic synthesis of primary studies of interventions and a mega-synthesis of reviews of patient experience of fatigue across different conditions. Focus groups were analysed by thematic analysis, and findings from all work packages were integrated in a final synthesis by the research team.

Publication metadata

Author(s): Leaviss J, Booth A, Coyle D, Daly G, Davis S, Dawes H, Deary V, Dwivedi K, Forsyth JE, Fryer K, McCormick S, James MM-S, Newton J, Ren S, Rooney G, Sutton A, Mon-Yee M, Burton C

Publication type: Article

Publication status: Published

Journal: Health Technology Assessment

Year: 2026

Volume: 30

Issue: 53

Print publication date: 01/06/2026

Online publication date: 01/06/2026

Acceptance date: 02/04/2018

Date deposited: 21/07/2026

ISSN (print): 1366-5278

ISSN (electronic): 2046-4924

Publisher: NIHR Journals Library

URL: https://doi.org/10.3310/GJCB1006

DOI: 10.3310/GJCB1006

Data Access Statement: All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review.

PubMed id: 42366788

Altmetrics

Funding

Share