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

Patient Educ Couns. 2022 Jun;105(6):1362-1378. doi: 10.1016/j.pec.2021.09.016. Epub 2021 Sep 14.

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% 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 inconsistent. 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 to populations and contexts.

Keywords: Chronic disease; Fatigue; Patient education; Quality of life; Self-management.

Publication types

  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fatigue / etiology
  • Fatigue / therapy
  • Humans
  • Multiple Sclerosis* / complications
  • Neoplasms* / complications
  • Neoplasms* / therapy
  • Quality of Life
  • Self-Management*