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

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 re-ported 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 incon-sistent. 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 popula-tions and contexts. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

This study systematically reviewed the effectiveness of fatigue self-management education (SME) on fatigue and quality of life (QoL) in individuals with disease-related fatigue. The results showed that 46% of the studies reported statistically significant improvements in fatigue and QoL. The evidence suggests a positive effect of SME in persons with cancer and multiple sclerosis. However, the overall evidence on the effectiveness of SMEs on fatigue and QoL is limited and inconsistent.