A Cochrane review [Abstract]1 included 27 RCTs with a total of 3324 subjects with cancer. Psychosocial interventions included yoga, giving information on cancer, activity management, energy conservation, techniques to manage stress, problem solving or teaching patients coping strategies. In 5 studies the intervention was specifically focused on fatigue, all the other interventions focused on other aspects, such as depression, anxiety, pain and quality of life. 7 studies reported significant effects of the psychosocial intervention on fatigue. In 3 studies the effect was maintained at follow-up. Effect sizes varied between 0.17 to 1.07. The effectiveness of interventions specific for fatigue was significantly higher (80%) compared to interventions not specific for fatigue (14%). Four of the five studies specifically focused on fatigue were effective. Of other 22 studies 3 were effective in reducing fatigue, and these interventions had a more general approach and varied strongly in duration and content.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patient characteristics, interventions and outcome measures) and study quality (inadequate allocation concealment, inadequate intention-to-treat adherence).
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