Approach to Fatigue in Primary Care: A Practical Diagnostic Framework for General Practitioners

Area of Science:

• General Practice
• Internal Medicine
• Diagnostic Medicine

Background:

• Fatigue is a frequent primary care complaint with complex causes.
• It can range from benign, self-limiting conditions to early signs of severe illness.
• Distinguishing acute (transient) from chronic fatigue (≥6 weeks) is crucial for diagnosis.

Purpose of the Study:

• To present a practical, structured diagnostic framework for managing fatigue in primary care.
• To guide general practitioners in evaluating and managing patients presenting with fatigue.
• To differentiate between various causes of fatigue, including physical, psychological, and lifestyle factors.

Main Methods:

• A narrative literature review was performed using PubMed and Google Scholar.
• Searches focused on English articles from 2010 onwards, using terms like 'fatigue,' 'primary care,' and 'chronic fatigue.'
• Key older references were included; a formal systematic search or risk-of-bias assessment was not conducted.

Main Results:

• Fatigue causes are classified into primary/idiopathic, secondary, and psychosocial categories.
• A systematic approach involving history, examination, and targeted investigations is recommended.
• Identifying 'red flag' symptoms is vital for detecting serious conditions like malignancy or chronic infections.

Conclusions:

• General practitioners can effectively manage fatigue using a structured, patient-centered approach.
• This strategy aims to minimize unnecessary tests while ensuring early detection of serious diseases.
• Timely and accurate diagnosis improves patient outcomes for fatigue presentations.