In a controlled trial of patients who reported the symptom cluster of pain and fatigue while receiving chemotherapy, a nursing behavioral intervention produced improvements in quality of life and decreased symptom burden relative to usual care.[52,53][Level of evidence: I] These intriguing results need to be further explored in patient populations other than women with breast or gynecologic malignancies.
As researchers and practitioners learned with pain, misconceptions and a lack of knowledge may prove to be patient- and provider-related barriers to successful assessment and management. A quasi-experimental study tested a multisystem educational approach to improving both pain and fatigue management. The approach consisted of the following:
- Education and assessment of patients regarding the management of pain and fatigue, with phone calls every 2 weeks for 3 months.
- Education of providers about pain and fatigue assessment and management, including monthly newsletters.
- An effort to engage with an internal advisory board.
- Efforts aimed toward research nurses to refer earlier to supportive care services.
Over a 3-month period, the educational intervention resulted in increases in knowledge and a decrease in barriers related to management of pain and fatigue. Of note, important patient barriers related to fatigue management included the following beliefs:[Level of evidence: II]
- Fatigue is inevitable.
- Fatigue can indicate worsening of disease.
- Treating the cancer is more important than treating fatigue.
- Reporting fatigue will cause a patient to be perceived as a complainer.
Current Clinical Trials
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about fatigue and anemia that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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