P99 A service evaluation of fatigue in liver disease in a level 2 liver centre: patient experience, clinical engagement, and perceived support

<h3>Introduction</h3> Fatigue is one of the most commonly reported and debilitating symptoms in chronic liver disease 1, yet it remains poorly understood and often under-addressed in clinical practice. It significantly impairs quality of life and daily functioning. Our patient cohort ranges from students, those of working age to the elderly. This study aims to quantify the prevalence and impact of fatigue, evaluate the extent of patient-provider communication regarding fatigue, and assess perceived management support among liver disease patients. <h3>Methods</h3> A 10-item structured questionnaire was distributed to 50 adult patients with liver disease through the outpatient setting. The questionnaire assessed fatigue frequency and severity. Questions were asked on its impact on daily and emotional functioning, and whether fatigue had been acknowledged or addressed by their healthcare providers. Patient confidence in managing their fatigue was also evaluated. <h3>Results</h3> Fatigue was commonly reported in 97% of patients: 80% experienced physical tiredness at least ‘sometimes,’ with 60% rating their fatigue as moderate or greater. Daily activities were impacted in 76% of respondents to some degree. Emotional well-being was also affected, with 42% experiencing moderate to extreme emotional burden. Despite this, healthcare engagement was limited. Only 6% reported their doctor had thoroughly discussed fatigue, while over a third (36%) initiated the discussion themselves. The majority (56%) felt their fatigue was not taken seriously (’not really,’ ‘not at all,’ or ‘not sure’), and 74% had received no advice or strategies for management. Confidence in self-management was mixed: 40% expressed some degree of confidence, while another 40% were neutral and 20% reported low confidence. <h3>Discussion</h3> The findings highlight a significant disconnect between patient experience and clinical engagement with fatigue in liver disease. While fatigue is widespread and affects both physical and emotional functioning, most patients feel unsupported and lack guidance on management. There is a critical need for routine assessment of fatigue in hepatology care and the development of evidence-based interventions to support patient self-management. Enhancing awareness among healthcare providers to address this important symptom will potentially improve quality of life. There is suggestion that integrating patient-reported outcomes may improve care quality overall. <h3>Reference</h3> Swain MG, Jones DEJ. Fatigue in chronic liver disease: New insights and therapeutic approaches. Liver Int. Jan 2019;39(1):6–19. doi:10.1111/liv.13919