Abstract
The purpose of the present systematic review was to develop a practice guideline to inform health care providers about screening, assessment, and effective management of cancer-related fatigue (crf) in adults. The internationally endorsed adapte methodology was used to develop a practice guideline for pan-Canadian use. A systematic search of the literature identified a broad range of evidence: clinical practice guidelines, systematic reviews, and other guidance documents on the screening, assessment, and management of crf. The search included medline, embase, cinahl, the Cochrane Library, and other guideline and data sources to December 2009. Two clinical practice guidelines were identified for adaptation. Seven guidance documents and four systematic reviews also provided supplementary evidence to inform guideline recommendations. Health professionals across Canada provided expert feedback on the adapted recommendations in the practice guideline and algorithm through a participatory external review process. Practice guidelines can facilitate the adoption of evidence-based assessment and interventions for adult cancer patients experiencing fatigue. Development of an algorithm to guide decision-making in practice may also foster the uptake of a guideline into routine care.
Highlights
Cancer-related fatigue can be experienced at all phases of the disease trajectory
Practice guidelines can facilitate the adoption of evidence-based assessment and interventions for adult cancer patients experiencing fatigue
Twelve guidelines were excluded: five because they either were based on data produced before 2003 or were not guidelines for practice; four, because they were not specific to cancer patients; and three, because they did not address crf management in a comprehensive manner
Summary
Cancer-related fatigue (crf) can be experienced at all phases of the disease trajectory. Prevalence rates for crf are reported to range from 70% to 100% during active treatment and to be about 30% in post-treatment survivors[1,2,3,4,5]. Definitions of crf vary, elements include a subjective feeling of tiredness or exhaustion, prompted by cancer or treatment and disproportionate to the level of recent exertion, that is not relieved by rest and that interferes with usual daily activities[6,7]. Cancer-related fatigue is differentiated from fatigue experienced in the daily life of the general adult population[6]. Because crf interferes with daily living and personal and social roles within family and community, it has a negative effect on quality of life[8,9,10]
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