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Utilisation of Non-pharmacological Interventions for Management of Cancer-related Fatigue in Palliative Care Services – An Audit Cycle

Indian J Palliat Care. 2026 Apr-Jun;32(2):207-211. doi: 10.25259/IJPC_440_2025. Epub 2026 May 12.

ABSTRACT

OBJECTIVES: Cancer-related fatigue (CRF) is a debilitating symptom that significantly affects the quality of life of patients with cancer. Effective management requires accurate documentation and timely implementation of non-pharmacological interventions (NPIs), which are considered first-line strategies. This study aimed to assess the documentation of CRF and NPIs in palliative care and evaluate the impact of a standardized operating procedure (SOP) on documentation compliance. The aim of the study is to assess the documentation of CRF and NPIs in palliative care and evaluate the impact of implementing a standardised operating procedure (SOP) on documentation compliance.

MATERIALS AND METHODS: A retrospective audit was conducted in two phases: pre-multidisciplinary team (MDT) induction and post-MDT induction, followed by a re-audit after six months. Documentation rates for CRF and NPIs were statistically analysed, and associated symptom clusters were identified using Epi Info software (Version 7.6.2).

RESULTS: CRF documentation improved from 67% in 2021 to 84% in 2022, and further to 98.5% (February 2023) and 89.3% (March 2023) and 96.7% (September 2023). NPI documentation increased from 0% in 2021 to 36% in 2022, and subsequently to 86.5%, 89.9%, and 86.5% in re-audits. Significant symptom clusters associated with CRF included loss of appetite (p < 0.01), loss of well-being (p < 0.001), and breathlessness (p < 0.01).

CONCLUSION: Implementation of an SOP significantly improved CRF and NPI documentation. Identification of key symptom clusters provides important insights for targeted interventions and future research in palliative care.

PMID:42233144 | PMC:PMC13224299 | DOI:10.25259/IJPC_440_2025

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