Fatigue bei Krebs: Wie (gut) sind Betroffene an onkologischen Einrichtungen in Deutschland versorgt?

Background

One of the most common sequelae of cancer and/or its treatment is cancer-related fatigue (CRF). For those affected, CRF is often accompanied by considerable, even long-term impairment. This makes it all the more important to examine how care is provided in Germany and to what extent guideline recommendations are implemented in clinical practice.

Methods

In a Germany-wide questionnaire survey, inpatient and outpatient oncological cancer care facilities were asked to describe their approach to CRF (information and education, screening, diagnostics), local treatment options, and clinical trials.

Results

A total of 145 facilities participated, including 11 comprehensive cancer centers, 35 organ-specific cancer centers, 22 hospitals with a (hemato-)oncology unit, 29 outpatient (hemato-)oncology practices, 48 outpatient cancer counseling units. Nearly all the facilities reported that patients are provided verbal health information (per groups: 90.9%, 88.6%, 90.9%, 96.9%, 72.9%); less frequently in written form (90.9%, 54.3%, 59.1%, 48.3%, 87.5%). A systematic screening for CRF is conducted in up to one-third of the facilities (per groups: 27.3%, 20.0%, 31.8%, 17.2%, 8.3%). A standardized procedure for further clarification of CRF is available at a small number of institutions (0%, 11.4%, 13.6%, 6.9%, 2.1%). Exercise (90.9%, 82.9%, 72.7%, 79.3%, 89.6%) and psychotherapeutic services (90.9%, 68.6%, 86.4%, 62.1%, 68.8%) are most frequently actively recommended to patients with CRF across the facility groups.

Discussion

With regard to the systematization of screening and diagnosis of CRF as well as the provision of information material, there is a clear discrepancy between guideline recommendations and everyday clinical practice.