[Cancer-related fatigue: How (good) is the quality of care at cancer care facilities in Germany?]

Abstract

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.