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Longitudinal Investigation of Cancer-related Fatigue and its Treatment: Knowledge, attitudes, needs, and current status of fatigue management in Germany (LIFT project)

Subject Area Public Health, Healthcare Research, Social and Occupational Medicine
Term from 2020 to 2026
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 438839893
 
Final Report Year 2025

Final Report Abstract

One of the most common and burdensome sequelae during and after cancer therapy is cancer-related fatigue (CRF), defined as a sense of physical, emotional, and/or cognitive tiredness or exhaustion in relation to cancer or its therapy. CRF impairs daily functioning, professional reintegration, social relations, and overall quality of life. To guide healthcare professionals in managing CRF in clinical practice, international associations such as the National Cancer Center Network or the European Society for Medical Oncology have formulated clear recommendations based on empirical evidence and consensus of experts. However, previous studies demonstrated lacking dissemination and implementation of these guidelines in some countries such as the US and Australia. As a result, many of those affected still feel poorly informed and left alone. As there was very little data on the situation on screening, counselling, and treatment of CRF in Germany, the LIFT project (Longitudinal Investigation of Cancer-related Fatigue) was launched with the aim to gain initial insights and derive starting points for improvements. It investigates the status of CRF management in Germany from the institutional, the healthcare professionals’, and the patients’ perspective. The multimodal approach included a comprehensive assessment of support offered by healthcare institutions, a survey and qualitative research among practitioners, and a longitudinal survey and qualitative research among cancer patients. From the institutional perspective, our study indicated several gaps in information and education about CRF. Among oncological institutions, only 67 % of those responding to our survey stated to provide written information on CRF, and online information was generally scarce. Standardized operating procedures in CRF management as recommended in the guidelines were hardly implemented. Although a multiprofessional, patient-centered care approach being most desirable, responsibilities in CRF management were mainly attributed to physicians. From the healthcare professionals’ perspective, there was an overall low awareness of CRF guidelines among physicians, nurses, and psycho-oncologists. Knowledge gaps existed regarding exercise as CRF treatment option among nurses (and partly also among psychooncologists), as well as knowledge-to-practice gaps among physicians for psychotherapeutic interventions and among psycho-oncologists for exercise. CRF as a topic was hardly covered in basic training and moderately in advanced training of all three professions. Accordingly, 75 % of patients five months after diagnosis had not been informed about CRF by their treating physician. Patients themselves tended not to address CRF due to lacking time during consultation, uncertainties whom to turn to, or worries on being taken for weak. In conclusion, various problems and needs with respect to current CRF care in Germany have been identified, and first steps for improvement have already been taken.

Link to the final report

https://doi.org/10.6097/305577

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