Measurement of fatigue in adults with anaemia: a scoping review of selected validated patient-reported instruments

Abstract Purpose Fatigue is a multidimensional patient-reported symptom and an important determinant of health-related quality of life (HRQoL) in adults with anaemia. This review aimed to map the use of selected, validated instruments for measuring fatigue in adults with anaemia, describe their frequency of use, and summarise reported associations with clinical, biological and other patient-reported outcomes. Methods A scoping review was conducted in accordance with PRISMA-ScR and Joanna Briggs Institute guidance. MEDLINE, PubMed, Embase, CENTRAL, the Cochrane Database of Systematic Reviews and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for English-language studies published from January 2000 to June 2025. Eligible studies included adults described by study authors as having anaemia and used at least one pre-specified validated fatigue instrument. Study selection and data charting were undertaken independently by two reviewers, and findings were synthesised descriptively. Results Of 5,481 records identified, 373 studies were included. The SF-36 vitality subscale ( n = 207, 55.5%) and FACIT-Fatigue ( n = 95, 25.5%) were the most frequently used instruments; 27 studies used more than one pre-specified instrument. Overall, 270 studies (72.4%) reported a statistically significant association between fatigue and at least one clinical, biological or treatment-related variable. Haemoglobin concentration or anaemia status was the most frequently reported correlate ( n = 110 of 270, 40.7%). Instrument choice, study populations and reporting practices were highly heterogeneous. Conclusions Fatigue measurement in adults with anaemia is inconsistent and commonly relies on a generic HRQoL subscale rather than a fatigue-specific instrument. The frequency with which an instrument is used should not be interpreted as evidence that it is optimal. Consensus on a core outcome set for fatigue in anaemia [1], clearer reporting of anaemia and fatigue, and evaluation of instrument validity, responsiveness and interpretability across anaemia populations are needed.