Current non-pharmacological practices for cancer-related fatigue in oncology rehabilitation: results of a national provider survey.
Cancer-related fatigue (CRF) is one of the most common side effects of cancer treatment, yet there is little consensus on best non-pharmacologic practices to manage this debilitating side effect. The purpose of this study was to describe current non-pharmacologic practice patterns for managing CRF and barriers to rehabilitation.
An electronic survey, developed by the authors using the CHERRIES checklist, was piloted via REDCap™ by nine participants. Data collected included demographics, clinical experience, frequency (none of the time, some of the time, and all of the time) of 15 common non-pharmacologic CRF interventions derived by expert consensus, effectiveness of interventions, and barriers to care for CRF. The survey took approximately 7 min to complete and was distributed via emails or flyers to cancer support groups, listservs, recruitment flyers, and word of mouth. All analyses were descriptive, including frequencies and percentages, and were performed using Microsoft Excel.
One hundred ninety-seven rehabilitation providers completed the survey: physical therapy (60%), occupational therapy (20%), speech-language pathology (9%), and exercise physiology (5%). All disciplines indicated frequently applying more than one of the following within their CRF interventions: therapeutic activities (78%), aerobic/strengthening/flexibility exercise (73.1%), energy conservation strategies (57.4%), and self-management education (48.2%). All professions measured the effectiveness of their fatigue interventions using patients' subjective reports (e.g., fatigue severity). Barriers to receiving care were "appointment fatigue" and financial constraints.
When developing CRF clinical practice guidelines, current rehabilitation practice patterns and survivors' barriers to care should be considered along with the highest level of evidence-based interventions.
An electronic survey, developed by the authors using the CHERRIES checklist, was piloted via REDCap™ by nine participants. Data collected included demographics, clinical experience, frequency (none of the time, some of the time, and all of the time) of 15 common non-pharmacologic CRF interventions derived by expert consensus, effectiveness of interventions, and barriers to care for CRF. The survey took approximately 7 min to complete and was distributed via emails or flyers to cancer support groups, listservs, recruitment flyers, and word of mouth. All analyses were descriptive, including frequencies and percentages, and were performed using Microsoft Excel.
One hundred ninety-seven rehabilitation providers completed the survey: physical therapy (60%), occupational therapy (20%), speech-language pathology (9%), and exercise physiology (5%). All disciplines indicated frequently applying more than one of the following within their CRF interventions: therapeutic activities (78%), aerobic/strengthening/flexibility exercise (73.1%), energy conservation strategies (57.4%), and self-management education (48.2%). All professions measured the effectiveness of their fatigue interventions using patients' subjective reports (e.g., fatigue severity). Barriers to receiving care were "appointment fatigue" and financial constraints.
When developing CRF clinical practice guidelines, current rehabilitation practice patterns and survivors' barriers to care should be considered along with the highest level of evidence-based interventions.
Authors
Harrington Harrington, Lee Lee, Fleischer Fleischer, Wood Wood, Cohn Cohn, Malone Malone, Fisher Fisher
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