Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Moira Stewart


The experience of fatigue has been a common problem among community populations for decades. The symptom of fatigue is also a frequent health complaint in primary care practices. Fatigue patients have been shown to be significantly high users of health care resources, particularly when compared to non-fatigued patient populations. To date, an understanding of the presence and the impact of the symptom of fatigue within the context of the Canadian health care system has been understudied.

The objective of this research was to determine the number of patients who were suffering from the symptom of fatigue within a primary care setting and to explore the determinants of their health care utilization patterns. Furthermore, these patterns of health care use were compared to a non-fatigue symptom patient population, who were also from a primary care setting. The data were extracted from a longitudinal electronic medical record database, which captures details of primary care encounters throughout Southwestern Ontario.

The fatigue symptom patients were found to experience a large complex of co-occurring morbidity and a markedly high level of referral following their visit with the symptom of fatigue. As well, the fatigue symptom patients were found to have an increased number of subsequent visits to their primary care provider and an increased number of investigations during a one year follow-up period, when compared to the non-fatigue symptom group.

These findings begin to create an understanding of fatigue symptom patients, their complex of morbidity, and their subsequent health care use patterns. This information will help to improve the management of fatigue symptom patients in Canadian primary care practices and in the Canadian health care system more broadly.