• Michael Hatzakis, Aaron P Turner, Rhonda M Williams, James D Bowen, Arthur A Rodriquez, and Jodie K Haselkorn.
• Department of Veterans Affairs, Puget Sound Health Care System, Seattle, WA 98108, USA. michael.hatzakis@med.va.gov
• Arch Phys Med Rehabil. 2005 Jul 1;86(7):1376-80.

ObjectiveTo determine predictors of fatigue-modifying medication use.DesignCross-sectional cohort.SettingVeterans Health Administration (VHA) facilities.ParticipantsVeterans with multiple sclerosis (MS) in the VHA in the northwestern United States from 1995 to 2000.InterventionsNot applicable.Main Outcome MeasuresA self-administered survey distributed by mail sought information from veterans with MS about demographics, symptoms, barriers to care, and disease characteristics. The variables were compared with prescriptions for fatigue-modifying medications during the study period.ResultsOf 1032 patients, 451 (44%) completed the survey, and 306 (68%) reported moderate or high fatigue levels. Only 40% of the 306 were prescribed fatigue-modifying medications. Those using specialized fatigue services or who received care at tertiary centers were more likely to receive fatigue treatments. Patient-perceived barriers to accessing care and other patient characteristics were not associated with prescription rates.ConclusionsFatigue is undertreated among veterans with MS. However, there is considerable variability in the provision of fatigue care. Interventions to improve the quality and uniformity of fatigue care are warranted.

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