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Published on: May 31, 2016
Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue
Paul B Jacobsen1, Kristine A Donovan, Susan T Vadaparampil
1Health Outcomes and Behavior Program, Moffitt Cancer Center and University of South Florida, 12902 Magnolia Drive, Tampa FL 33612, USA. paul.jacobsen@moffitt.org
Context:
Fatigue is among the most common and distressing symptoms experienced by cancer patients.
Objective:
This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients.
Data Sources:
MEDLINE, PsycINFO, and CINAHL.
Study Selection:
Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed.
Extraction:
Forty-one trials were reviewed and 30 were included in a meta-analysis.
Data Synthesis:
Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02- .16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d-sub(w) = .10, 95% CI = .02-.18) but not activity-based interventions (d-sub(w) = .05, 95% CI = -.08 - .19).
Conclusions:
Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base.
