The hidden cost of chronic fatigue to patients and their families

Centre for the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, King's College, London, UK.
BMC Health Services Research (Impact Factor: 1.71). 03/2010; 10(1):56. DOI: 10.1186/1472-6963-10-56
Source: PubMed


Nearly 1 in 10 in the population experience fatigue of more than six months at any one time. Chronic fatigue is a common reason for consulting a general practitioner, and some patients report their symptoms are not taken seriously enough. A gap in perceptions may occur because doctors underestimate the impact of fatigue on patients' lives. The main aim of the study is to explore the economic impact of chronic fatigue in patients seeking help from general practitioners and to identify characteristics that explain variations in costs.
The design of study was a survey of patients presenting to general practitioners with unexplained chronic fatigue. The setting were 29 general practice surgeries located in the London and South Thames regions of the English National Health Service. Use of services over a six month period was measured and lost employment recorded. Regression models were used to identify factors that explained variations in these costs.
The mean total cost of services and lost employment across the sample of 222 patients was 3878 pounds for the six-month period. Formal services accounted for 13% of this figure, while lost employment accounted for 61% and informal care for 26%. The variation in the total costs was significantly related to factors linked to the severity of the condition and social functioning.
The economic costs generated by chronic fatigue are high and mostly borne by patients and their families. Enquiry about the functional consequences of fatigue on the social and occupational lives of patients may help doctors understand the impact of fatigue, and make patients feel better understood.

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    • "Chronic fatigue syndrome (CFS) or myalgic encephalitis (ME) is characterized by severe, disabling, medically unexplained fatigue that is not alleviated by rest and lasts for at least 6 months [Tables 1 and 2].[12] CFS/ME causes high levels of disability and burden to affected individuals, families, and society; and is associated with high economic costs in the UK.[34] The National Institute for Clinical Excellence (NICE) guideline for CFS/ME in England for CFS/ME emphasizes the importance of confident diagnosis in primary care, starting treatment early, and working in partnership with people with CFS/ME to manage the condition.[2] "
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    • "That women and younger people are less likely to discontinue work is consistent with findings from a US community-based study [13]. A UK-based study of patients presenting with chronic fatigue in a primary care setting reported that loss of employment over the preceding 6-month period had a mean cost per person of £2,350 (95% CI £1734 - £2966) although it is unclear whether all of these patients had CFS/ME [27]. The equivalent cost from our data (based on the weighted average of half the mean annual income) would be £5,753. "
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