Evaluation of an Outpatient Consultation Model for Cancer-Related Fatigue by the Bavarian Cancer Society: Service...

Cancer-related fatigue (CRF) is a common, debilitating consequence of cancer and its treatment, yet it remains frequently underrecognized and undertreated. As a result, many patients receive neither targeted assessment nor appropriate treatment recommendations. This study evaluates the utilization, intervention uptake, and patient satisfaction with a specialized CRF consultation service at 10 cancer counseling centers in Bavaria, Germany.

A prospective, observational, multicenter study was conducted between March 2022 and February 2024. Patients with a cancer diagnosis and clinically relevant fatigue were eligible for CRF consultation. Of the 557 patients who received a CRF consultation, 524 participated in the study, of whom 496 were clinically diagnosed with CRF; 447 completed the follow-up.

Among patients with confirmed CRF (n = 496), a shared decision-making process involving patient and clinician resulted in the selection of three evidence-based interventions in most cases (80%), most commonly physical activity (63%), energy conservation and activity management (45%), and mind-body approaches (39%). At follow-up (n = 447), 44% of the recommended interventions had been implemented either fully or to a large extent. Even for the most frequently selected interventions, implementation remained moderate (33% to 56%). Barriers to implementation-which were primarily related to health limitations, family and work commitments, and limited service availability-were reported by 87% of the patients. Despite these challenges, satisfaction with the consultation was high (mean value of 1.2 and 1.4, on a scale from 1 = very good to 6 = very poor), and patients expressed strong support for continuing the service. Suggestions for improvement included shorter waits, assistance in implementing interventions, and support with administrative procedures.

The CRF consultation service of the Bavarian Cancer Society is a feasible, well-accepted, and patient-centered approach that addresses a major unmet need in cancer care. This model may serve as a best practice example for similar initiatives nationally and internationally. Long-term implementation in the healthcare system requires structural integration, sustainable funding, and policy recognition.

German Clinical Trials Register: DRKS00028264.