Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis

Semin Oncol. 2023 Feb-Apr;50(1-2):49-59. doi: 10.1053/j.seminoncol.2023.03.004. Epub 2023 Mar 21.

Abstract

Introduction: Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults.

Material and methods: We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity.

Results: We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions).

Conclusions: There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories.

Prospero registration: CRD42020194258.

Keywords: Adults; Cancer; Fatigue; Nonpharmacologic interventions; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Fatigue* / complications
  • Fatigue* / therapy
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / therapy
  • Quality of Life
  • Systematic Reviews as Topic