Clinical evaluation of fatigue in MS using the Brief Fatigue and Associated Symptoms Scale

Abstract

Background Fatigue negatively impacts on the lives of people with multiple sclerosis (MS). While primary MS-related fatigue may be difficult to treat, the authors hypothesised that secondary fatigue may respond to targeted strategies addressing causal factors such as pain, depression and sleep disturbance. Methods A prospective, multi-centre study was conducted over six months to establish the clinical utility and efficacy of a practical screening tool for the assessment of fatigue and associated factors: the Brief Fatigue and Associated Symptoms Scale (BFASS). A total of 158 people with MS attending outpatient clinics were recruited across three sites. Results The BFASS provided a structured approach to assessment and increased referrals by MS nurses for clinically significant contributors to fatigue. As expected, severity of fatigue was correlated with pain, depression, daytime sleepiness and quality of life scores. Mean scores for fatigue also showed a small reduction from baseline (39 ± 19) to 6-month follow-up (35 ± 19). From the perspective of MS nurses, implementing a screening tool for fatigue and associated factors uncovered previously hidden problems and it improved symptom management. Conclusion The BFASS is recommended for MS clinicians as a brief, structured assessment of fatigue, providing clinically meaningful cut-offs for referral, and facilitating conversations about hidden MS-related problems that reduce quality of life.