Cancer-Related Fatigue Protocol Using a Personalized Self-Management Program

Abstract

Research Objectives Cancer-related fatigue (CRF) is a common and persistent side effect of cancer that interferes with function. The RISE (Reinvent, Integrate, Strengthen, Expand) cancer survivorship self-management program uses an occupation-based framework to develop individually-tailored, health-related goals. The objective of this study is to determine baseline fatigue levels in RISE participants and to pilot a novel CRF self-management protocol in this population. Design A pilot study testing a new CRF protocol for cancer survivors attending the RISE program. Setting RISE takes place primarily via HIPAA-compliant videoconference and is delivered by a licensed occupational therapist in an outpatient clinic at Cedars-Sinai Medical Center. Participants 15 diverse cancer survivors referred to the RISE program by medical oncologists at Cedars-Sinai Medical Center. Eligibility criteria include history of cancer diagnosis, completion of primary cancer treatment, and an oncologist-identified limitation in instrumental activities of daily living (IADL) secondary to CRF. Interventions The 12-session CRF protocol contains the following modules: 1) energy conservation, 2) physical activity, 3) cognitive behavioral therapy, 4) sleep, 5) mindfulness, and 6) diet. Sessions consist of patient education, motivational interviewing, and collaborative problem-solving to develop strategies and skills for self-management of CRF and achievement of valued IADL. The protocol is individually tailored to participants’ strengths, challenges, and priorities. Main Outcome Measures A standardized fatigue severity survey item on the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health questionnaire. Results The 15 participants were survivors of breast cancer (n=10), prostate cancer (n=1), melanoma (n=1), non-Hodgkin's lymphoma (n=1), myeloid leukemia (n=1), and endometrial (n=1) cancer. Fourteen participants were female, and the average age was 50.6. Average fatigue severity score at baseline was 2.3 on a 5-point Likert scale with 5 representing “none” and 1 representing “very severe.” Conclusions RISE participants demonstrate moderate to severe fatigue at baseline. Given the functional implications of CRF, the RISE CRF protocol will provide cancer survivors with needed self-management interventions to enable participation in IADL. Fatigue severity data post-RISE intervention (forthcoming) will inform best practice for rehabilitation professionals working with CRF in cancer survivors. Author(s) Disclosures N/A. Cancer-related fatigue (CRF) is a common and persistent side effect of cancer that interferes with function. The RISE (Reinvent, Integrate, Strengthen, Expand) cancer survivorship self-management program uses an occupation-based framework to develop individually-tailored, health-related goals. The objective of this study is to determine baseline fatigue levels in RISE participants and to pilot a novel CRF self-management protocol in this population. A pilot study testing a new CRF protocol for cancer survivors attending the RISE program. RISE takes place primarily via HIPAA-compliant videoconference and is delivered by a licensed occupational therapist in an outpatient clinic at Cedars-Sinai Medical Center. 15 diverse cancer survivors referred to the RISE program by medical oncologists at Cedars-Sinai Medical Center. Eligibility criteria include history of cancer diagnosis, completion of primary cancer treatment, and an oncologist-identified limitation in instrumental activities of daily living (IADL) secondary to CRF. The 12-session CRF protocol contains the following modules: 1) energy conservation, 2) physical activity, 3) cognitive behavioral therapy, 4) sleep, 5) mindfulness, and 6) diet. Sessions consist of patient education, motivational interviewing, and collaborative problem-solving to develop strategies and skills for self-management of CRF and achievement of valued IADL. The protocol is individually tailored to participants’ strengths, challenges, and priorities. A standardized fatigue severity survey item on the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health questionnaire. The 15 participants were survivors of breast cancer (n=10), prostate cancer (n=1), melanoma (n=1), non-Hodgkin's lymphoma (n=1), myeloid leukemia (n=1), and endometrial (n=1) cancer. Fourteen participants were female, and the average age was 50.6. Average fatigue severity score at baseline was 2.3 on a 5-point Likert scale with 5 representing “none” and 1 representing “very severe.” RISE participants demonstrate moderate to severe fatigue at baseline. Given the functional implications of CRF, the RISE CRF protocol will provide cancer survivors with needed self-management interventions to enable participation in IADL. Fatigue severity data post-RISE intervention (forthcoming) will inform best practice for rehabilitation professionals working with CRF in cancer survivors.