Review What is the effect of education on fatigue in adults with neurological conditions? A systematic review and meta-analysis 2025 Simpson et al

[Andy]

Abstract​

Objective​

To determine the effect of education programs on fatigue outcomes in people with neurological conditions.

Data sources​

MEDLINE, CINAHL, EMBASE, PEDRO until May 2025, according to PRISMA guidelines.

Review methods​

Systematic review with meta-analysis of randomised controlled trials comparing education versus no education/other intervention on the outcome of fatigue for people with neurological conditions. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias Tool. Pooled effects were calculated using standard mean difference (SMD).

Results​

We included 19 clinical trials of education for fatigue (n = 1970 participants) in five different neurological conditions. Education duration ranged from 4 to 12 weeks, 79% (n = 15) of trials included people with multiple sclerosis and 18% (n = 3) included people with stroke. Most education (11 trials, 58%) was delivered in a group setting. Education reduced fatigue compared with usual care by a SMD −0.28, 95% CI [−0.45 to −0.11]. Greater benefits for fatigue were observed when education was delivered one-to-one (SMD −0.44, 95% CI [−0.77 to −0.12]) than in group sessions (SMD −0.17, 95% CI [−0.36 to 0.01]). Mode of delivery (in-person versus telehealth) did not appear to influence the effect of education for fatigue.

Conclusions​

Fatigue education programs may improve fatigue for people with neurological conditions. One-to-one delivered sessions may have greater benefits than group programs and remote delivery could improve accessibility for people living in regional and rural locations.

Open access

 

[Andy]

Health-related education is designed to improve knowledge, health literacy and influence motivation. Active education interventions use a variety of behaviour science methods however techniques are challenging to define, differentiate and are often poorly reported in clinical trials.

The experimental intervention was fatigue education programs. All trials included some form of behaviour change strategy, such as cognitive behavioural therapy principles and/or self-management principles. Similarly, all trials provided education on energy conservation principles and/or general fatigue management strategies.

So, yet again, the effect is most likely to be in how much the 'education' manages to change how people answer questionnaires.

 

[SNT Gatchaman]

Unfortunately for many neurological conditions, fatigue research is either in its infancy, possibly because of the complexity of the phenomenon and lack of mechanistic understanding. Consequently, it is challenging for health professionals to know what to offer patients.

Indeed. Hence "education".

 

[Turtle]

Why would patients need education on fatigue, they are the experts with lived experience.
Pure hybris from professionals. We don't know anything, but we can educate others with ........????????
Listening to the patients would be a good place to start.

 

[Snow Leopard]

I've never met a medical practitioner who understands fatigue at all.

 

[NelliePledge]

“reeducation”