Fatigue self-management education in persons with disease-related fatigue: A comprehensive review of the effectiveness on fatigue and quality of life

Hersche-Cupelli, Ruth and Roser, Katharina and Weise, Andrea and Gisela, Michel and Barbero, Marco (2021) Fatigue self-management education in persons with disease-related fatigue: A comprehensive review of the effectiveness on fatigue and quality of life. Patient Education and Counseling. (In Press)

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Abstract

Objectives: To systematically synthesize the effectiveness of fatigue self-management education (SME) on fatigue and quality of life (QoL) in persons with disease-related fatigue, and to describe the intervention characteristics. Methods: We systematically reviewed the literature on SMEs in people with disease-related fatigue. We included randomized controlled trials (RCT), which aimed to improve self-management skills for fatigue in daily life. We synthesized the effectiveness and mapped the intervention characteristics. Results: We included 26 RCTs studying samples from eight disease groups. At follow-up, 46% of studies reported statistically significant improvements on fatigue and 46% on QoL. For persons with cancer 6/8 and multiple sclerosis, 8/10 RCTs showed positive evidence in favor of SME. The range of effect sizes was wide (d: 0.0 - > 0.8). Delivery modalities (inpatient, outpatient, home), interactions (individual, group, remote), and duration [range (h): 1–17.5] varied. Conclusions: The overall evidence on the effectiveness of SMEs on fatigue and QoL is limited and insistent. For persons with cancer and multiple sclerosis, the evidence provides a positive effect. The RCTs with medium to large effect on QoL indicate the potential benefit of SMEs. Practical implication: Duration and peer interaction should be considered when tailoring SMEs popultions and contexts.

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