How can I effectively use screening tools to evaluate the severity and impact of chronic fatigue on a patient's daily life?

To effectively utilize screening tools to assess the severity and impact of chronic fatigue on a patient's daily functioning, follow these steps:

• Use clinical criteria and symptom checklists: Screen for key symptoms such as debilitating fatigue worsened by activity, post-exertional malaise, unrefreshing sleep, and cognitive difficulties (brain fog). Confirm symptoms have persisted for at least 6 weeks in adults and significantly reduce occupational, educational, social, or personal activities compared to pre-illness levels ¹.
• Assess functional impact by severity categories: Classify severity based on the patient’s ability to perform daily activities:
  • Mild: Can self-care and do light domestic tasks, may still work or study but with reduced leisure/social activities.
  • Moderate: Reduced mobility, restricted in all daily living activities, usually stopped work/education, requires rest periods.
  • Severe: Unable to do most activities independently, severe cognitive difficulties, often housebound or bedbound.
  • Very severe: Bedbound all day, dependent on care, may require tube feeding ¹.
• Conduct a comprehensive medical assessment: Include symptom history, physical examination, psychological and social wellbeing assessment, and investigations to exclude other causes of fatigue (e.g., blood tests for anaemia, thyroid function, infections) ¹.
• Use patient-reported outcome measures and functional scales: Although not explicitly detailed in the guidelines, tools that quantify fatigue severity and impact on daily functioning (e.g., fatigue severity scales, activity diaries) can complement clinical assessment and help monitor changes over time ¹.
• Engage patients in discussions about their symptoms and functional limitations: This supports shared decision-making and helps tailor management plans according to severity and impact ¹.