Exploring the Use of Two Brief Fatigue Screening Tools in Cancer Outpatient Clinics

• Published in: Integrative cancer therapies Vol. 20; p. 1534735420983443
• Main Authors: Pearson, Elizabeth J., Drosdowsky, Allison, Edbrooke, Lara, Denehy, Linda
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2021; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Cancer; Demography; Fatigue; Fatigue, Treatment Side Effects, and Rehabilitation; Medical records; Outpatient care facilities; Pictographs; Statistical analysis; guideline implementation; prevalence; cancer-related fatigue; screening tool; clinical utility; screening practice
• ISSN: 1534-7354; 1552-695X
• DOI: 10.1177/1534735420983443

Purpose: Cancer fatigue guidelines recommend routine fatigue screening, with further assessment for people reporting moderate to severe fatigue. There is neither a gold-standard, nor a broadly accepted screening method, and knowledge about the impact of screening on care processes is limited. This study aimed to explore the feasibility of 2 fatigue screening methods and current clinical practice in cancer outpatient clinics. Methods: Hospital outpatients attending cancer clinics during 1 week completed a five-item survey: a numeric scale for current tiredness, 2 categorical pictorial scales rating tiredness last week and the impact of fatigue (Fatigue Pictogram), screening tool preference and help needed for survey completion. Participant demographics and fatigue documentation by clinical staff for that appointment were extracted from medical records. Analyses used descriptive statistics. Groups were compared using appropriate statistical tests. Results: Over 75% of participants rated their fatigue consistently as mild or significant on both screening tools. Of 1709 eligible outpatients, 533 (31%) completed the survey. Records were audited for 430 (81%) identifiable participants. Over half of the participants reported moderate or severe tiredness either “now” (237, 57%) and/or “last week” (226, 53%). Clinician documentation of fatigue seldom matched self-reports. Fatigue was rated as severe by 103 participants (24%), yet was noted in only 21 (20%) of these individuals’ clinical notes. Both screening tools were equally preferred. Conclusion: The numeric rating scale and Fatigue Pictogram are equally applicable for screening fatigue in cancer outpatient care. There is a high prevalence of clinically significant fatigue in a hospital outpatient setting that is not documented. Adequate care pathways for further management should be established alongside fatigue screening.