Use of formal and informal care among people with prolonged fatigue: a review of the literature

Prolonged fatigue is a common symptom in the community and a common complai nt in GPs' surgeries. The current consensus is that prolonged fatigue is mo st appropriately managed within primary care but that quality of care is pa tchy. Diagnosis is difficult and there is no conclusive evidence about effe ctive treatment. This can lead to confusion and controversy among lay peopl e and health professionals alike. Although the value of a positive doctor-p atient relationship is emphasized, general practice consultations are frequ ently experienced as difficult by both parties. Moreover, little is known a bout how people access other sources of care and information about prolonge d fatigue, such as alternative medicine, self-help groups, lay others, and self care, in conjunction with or as an alternative to care from health pro fessionals. This paper reviews the literature on the nature and extent of t he problem prolonged fatigue represents for primary care, and on the use of formal and informal care for prolonged fatigue.