Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials

Nina Higson-Sweeney; Aida Mikkola; Lucie Smith; Jawairya Shafique; Luke Draper; Kate Cooper; Barnaby D. Dunn; Maria E. Loades

doi:10.1016/j.jpsychores.2022.111070

Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials

Nina Higson-Sweeney, Aida Mikkola, Lucie Smith, Jawairya Shafique, Luke Draper, Kate Cooper, Barnaby D. Dunn, Maria E. Loades

Research output: Contribution to journal › Review article › peer-review

3 Citations (SciVal)

Abstract

Objective: Fatigue is common in adolescence and can be highly disabling if experienced persistently, with adverse psychosocial outcomes. There is a need to better understand what nonpharmacological treatments are available for adolescents suffering with persistent fatigue. The current review systematically identified, synthesised, and evaluated the evidence regarding nonpharmacological interventions for fatigue in adolescents, focusing on evaluating effectiveness, describing intervention components, and mapping interventions onto the behaviour change technique taxonomy (BCTT).
Methods: CENTRAL, EMBASE, PsycINFO, PubMed, and Web of Science were systematically searched for articles including (1) adolescents aged 10-19 years old, (2) fatigue as a primary or secondary outcome, (3) nonpharmacological interventions, and (4) randomised controlled trials. Study screening, data extraction, quality assessment, and BCTT mapping were performed independently by two reviewers. Findings were presented as a narrative synthesis, with interventions ranked by promise.
Results: 5,626 papers were identified and double-screened, resulting in the inclusion of 21 articles reporting 16 trials. Five interventions were classified as likely promising. Interventions often involved psychoeducation, cognitive behavioural therapy, and/or physical activity, incorporating various BCTT domains, most commonly shaping knowledge, repetition and substitution, and goals and planning. However, there did not seem to be any observable differences between fatigue-targeted and non-fatigue-targeted interventions. Overall study quality was mixed, particularly in relation to power and outcome measures.
Conclusion: There are several promising nonpharmacological interventions for adolescent fatigue, although further work is needed to determine effectiveness. Future trials need to ensure design rigour, focusing on adequate powering, validated outcome measures, and adhering to best practice reporting guidelines.

Original language	English
Article number	111070
Journal	Journal of Psychosomatic Research
Volume	163
Early online date	31 Oct 2022
DOIs	https://doi.org/10.1016/j.jpsychores.2022.111070
Publication status	Published - 31 Dec 2022

Bibliographical note

Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF2018-04-ST2-047). Dr Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are 21those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.

Funding Information:
We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.

Funding Information:
We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/ P000630 /1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.

Keywords

Adolescence
Adolescent health
Fatigue
Psychosocial intervention
Systematic review

ASJC Scopus subject areas

Clinical Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jpsychores.2022.111070Licence: CC BY

Cite this

Higson-Sweeney, N., Mikkola, A., Smith, L., Shafique, J., Draper, L., Cooper, K., Dunn, B. D., & Loades, M. E. (2022). Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials. Journal of Psychosomatic Research, 163, Article 111070. https://doi.org/10.1016/j.jpsychores.2022.111070

@article{b1eab54e22a1447598658803cc85ce84,

title = "Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials",

abstract = "Objective: Fatigue is common in adolescence and can be highly disabling if experienced persistently, with adverse psychosocial outcomes. There is a need to better understand what nonpharmacological treatments are available for adolescents suffering with persistent fatigue. The current review systematically identified, synthesised, and evaluated the evidence regarding nonpharmacological interventions for fatigue in adolescents, focusing on evaluating effectiveness, describing intervention components, and mapping interventions onto the behaviour change technique taxonomy (BCTT). Methods: CENTRAL, EMBASE, PsycINFO, PubMed, and Web of Science were systematically searched for articles including (1) adolescents aged 10-19 years old, (2) fatigue as a primary or secondary outcome, (3) nonpharmacological interventions, and (4) randomised controlled trials. Study screening, data extraction, quality assessment, and BCTT mapping were performed independently by two reviewers. Findings were presented as a narrative synthesis, with interventions ranked by promise.Results: 5,626 papers were identified and double-screened, resulting in the inclusion of 21 articles reporting 16 trials. Five interventions were classified as likely promising. Interventions often involved psychoeducation, cognitive behavioural therapy, and/or physical activity, incorporating various BCTT domains, most commonly shaping knowledge, repetition and substitution, and goals and planning. However, there did not seem to be any observable differences between fatigue-targeted and non-fatigue-targeted interventions. Overall study quality was mixed, particularly in relation to power and outcome measures.Conclusion: There are several promising nonpharmacological interventions for adolescent fatigue, although further work is needed to determine effectiveness. Future trials need to ensure design rigour, focusing on adequate powering, validated outcome measures, and adhering to best practice reporting guidelines. ",

keywords = "Adolescence, Adolescent health, Fatigue, Psychosocial intervention, Systematic review",

author = "Nina Higson-Sweeney and Aida Mikkola and Lucie Smith and Jawairya Shafique and Luke Draper and Kate Cooper and Dunn, {Barnaby D.} and Loades, {Maria E.}",

note = "Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF2018-04-ST2-047). Dr Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are 21those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. Funding Information: We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. Funding Information: We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/ P000630 /1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. ",

year = "2022",

month = dec,

day = "31",

doi = "10.1016/j.jpsychores.2022.111070",

language = "English",

volume = "163",

journal = "Journal of Psychosomatic Research",

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TY - JOUR

T1 - Nonpharmacological interventions for treating fatigue in adolescents

T2 - A systematic review and narrative synthesis of randomised controlled trials

AU - Higson-Sweeney, Nina

AU - Mikkola, Aida

AU - Smith, Lucie

AU - Shafique, Jawairya

AU - Draper, Luke

AU - Cooper, Kate

AU - Dunn, Barnaby D.

AU - Loades, Maria E.

N1 - Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF2018-04-ST2-047). Dr Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are 21those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. Funding Information: We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/P000630/1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. Funding Information: We would like to acknowledge Catherine Borwick for helping the research team to develop the search strategy for this review, and Dr. Rosalind Cooper for her input regarding the protocol and the search terms. We also want to thank Dr. Gemma Taylor for her insight into meta-analyses, and Dr. Rebecca Abbott, Morwenna Rogers, and Professor Obioha Ukoumunne from the University of Exeter for their help with calculating effect sizes. Funding: This work was supported by the Economic and Social Research Council [grant number ES/ P000630 /1]. Dr. Kate Cooper is funded by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2018-04-ST2-047). Dr. Maria Loades (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.

PY - 2022/12/31

Y1 - 2022/12/31

N2 - Objective: Fatigue is common in adolescence and can be highly disabling if experienced persistently, with adverse psychosocial outcomes. There is a need to better understand what nonpharmacological treatments are available for adolescents suffering with persistent fatigue. The current review systematically identified, synthesised, and evaluated the evidence regarding nonpharmacological interventions for fatigue in adolescents, focusing on evaluating effectiveness, describing intervention components, and mapping interventions onto the behaviour change technique taxonomy (BCTT). Methods: CENTRAL, EMBASE, PsycINFO, PubMed, and Web of Science were systematically searched for articles including (1) adolescents aged 10-19 years old, (2) fatigue as a primary or secondary outcome, (3) nonpharmacological interventions, and (4) randomised controlled trials. Study screening, data extraction, quality assessment, and BCTT mapping were performed independently by two reviewers. Findings were presented as a narrative synthesis, with interventions ranked by promise.Results: 5,626 papers were identified and double-screened, resulting in the inclusion of 21 articles reporting 16 trials. Five interventions were classified as likely promising. Interventions often involved psychoeducation, cognitive behavioural therapy, and/or physical activity, incorporating various BCTT domains, most commonly shaping knowledge, repetition and substitution, and goals and planning. However, there did not seem to be any observable differences between fatigue-targeted and non-fatigue-targeted interventions. Overall study quality was mixed, particularly in relation to power and outcome measures.Conclusion: There are several promising nonpharmacological interventions for adolescent fatigue, although further work is needed to determine effectiveness. Future trials need to ensure design rigour, focusing on adequate powering, validated outcome measures, and adhering to best practice reporting guidelines.

AB - Objective: Fatigue is common in adolescence and can be highly disabling if experienced persistently, with adverse psychosocial outcomes. There is a need to better understand what nonpharmacological treatments are available for adolescents suffering with persistent fatigue. The current review systematically identified, synthesised, and evaluated the evidence regarding nonpharmacological interventions for fatigue in adolescents, focusing on evaluating effectiveness, describing intervention components, and mapping interventions onto the behaviour change technique taxonomy (BCTT). Methods: CENTRAL, EMBASE, PsycINFO, PubMed, and Web of Science were systematically searched for articles including (1) adolescents aged 10-19 years old, (2) fatigue as a primary or secondary outcome, (3) nonpharmacological interventions, and (4) randomised controlled trials. Study screening, data extraction, quality assessment, and BCTT mapping were performed independently by two reviewers. Findings were presented as a narrative synthesis, with interventions ranked by promise.Results: 5,626 papers were identified and double-screened, resulting in the inclusion of 21 articles reporting 16 trials. Five interventions were classified as likely promising. Interventions often involved psychoeducation, cognitive behavioural therapy, and/or physical activity, incorporating various BCTT domains, most commonly shaping knowledge, repetition and substitution, and goals and planning. However, there did not seem to be any observable differences between fatigue-targeted and non-fatigue-targeted interventions. Overall study quality was mixed, particularly in relation to power and outcome measures.Conclusion: There are several promising nonpharmacological interventions for adolescent fatigue, although further work is needed to determine effectiveness. Future trials need to ensure design rigour, focusing on adequate powering, validated outcome measures, and adhering to best practice reporting guidelines.

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KW - Adolescent health

KW - Fatigue

KW - Psychosocial intervention

KW - Systematic review

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U2 - 10.1016/j.jpsychores.2022.111070

DO - 10.1016/j.jpsychores.2022.111070

M3 - Review article

SN - 0022-3999

VL - 163

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

M1 - 111070

ER -

Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

DSE application

Autism and Gender Dysphoria

Cite this

Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Projects

DSE application

Autism and Gender Dysphoria

Cite this