Update of the DEGAM-Guideline Fatigue
Neue Entwicklungen und Empfehlungengerman translation / full article
New Developments and Recommendations
Background: According to the rules of the National Association of Scientific Medical Colleges (AWMF) we performed a routine update for the German College of GPs’ and FPs’ (DEGAM) guideline about fatigue/tiredness
Methods: Systematic literature review, accompanying hand search, consensus conference with medical colleges and self-help-groups which are also involved in the management of fatigue/tiredness; “guideline-godfathers” complemented the content and patients’ versions and implementation aids were revised by DEGAM deputees.
Results: Key-messages of the present guideline were essentially confirmed. Depression is the main cause of primarily unexplained fatigue. Interventions with the best available evidence were cognitive-behavioral-therapy and physical activation. Supplements and slight modifications were necessary for some points especially for definitions regarding preventable dangerous developments in the short version, for new criteria regarding chronic fatigue syndrome as well as for still pending recommendations for the use of stimulants in cancer patients or neurologic diseases.
Conclusion: Fatigue as reason for encounter is still a challenge for family practicioners and needs a bio-psychic-social approach for diagnosis and therapy. FPs can adequately deal with this problem when using a basic diagnostic programme and- if needed for longstanding conditions- structured accompanying of the patients.