Du, S., Hu, L., Dong, J., Xu, G., Jin, S., Zhang, H., & Yin, H. (2015). Patient education programs for cancer-related fatigue: A systematic review. Patient Education and Counseling, 98, 1308–1319. 

• FINAL NUMBER STUDIES INCLUDED = 10 
• TOTAL PATIENTS INCLUDED IN REVIEW = 2,534
• SAMPLE RANGE ACROSS STUDIES: 30–282 patients
• KEY SAMPLE CHARACTERISTICS: Multiple types of cancer were represented across studies.

Interventions included exercise in eight studies, sleep hygiene in seven, relaxation training in six, and nutritional guidance in six. Six studies included the use of a booklet as supplement material. Four studies included telephone follow-up, and one was provided via an Internet-based program. The program duration ranged from 1 week to 12 weeks. Attrition rates ranged from 7%–46.7%. Two studies demonstrated significant reduction of fatigue with ES ranging from –0.76 to –1.41 (p < 0.001). Six studies concluded achieving a limited positive effect, with a small effect size and no statistical significance. One study showed no effect, and one showed worse outcomes in the intervention group. High heterogeneity existed across trials, so no meta-analysis was deemed appropriate.

Inconsistent evidence of effects of patient education programs on cancer-related fatigue existed across all 10 studies.

• Variability of cancer types, stages, treatments, and phases of care across studies
• Various types of control conditions could contribute to bias.
• Variability existed in program duration, methods of delivery, and follow-ups.
• High attrition existed in some studies.
• Many studies included exercise, which alone has been shown to be of benefit for fatigue.

Some mixed evidence exists regarding the effects of patient education programs on cancer-related fatigue, which are related to the variability in interventions that have been studied. More rigorous research is needed to sort out those program characteristics and populations of patients who can benefit most from educational interventions.