Which clinical practice guideline for cancer-related fatigue is the most suitable for application in Australia? (#168)
Fatigue is one of the most troublesome symptoms of cancer. It can occur at all stages of cancer and severe fatigue has been associated with functional impairment. A recent study indicated inconsistent use of guidelines for management of cancer-related fatigue by Australian oncology health professionals.
This research aimed to identify the most appropriate guideline for management of cancer-related fatigue for implementation in Australia.
A systematic literature search was used to identify clinical practice guidelines for CRF. Published quality appraisals were then used to short list guidelines of the highest quality of development. A consumer representative, a medical, nursing and allied health professional were recruited to independently appraise two guidelines. The AGREE-II instrument and Australia’s National Health and Medical Research Council (NHMRC) mandatory guideline standards were used in the appraisals.
Five guidelines met the inclusion criteria. The pan-Canadian and American Society of Clinical Oncology (ASCO) fatigue guidelines were selected for further appraisal based on the published appraisals. In the current study, the five out of six AGREE-II domain scores were higher for the pan-Canadian guideline (v.2.2015) than the ASCO but the differences were not statistically significant (p≤0.05). The poorest AGREE-II scores for both guidelines were in the domain ‘applicability’. The pan-Canadian guideline met 36 of the 54 NHMRC mandatory standards and the ASCO guideline met 18 standards. Neither guideline met any criteria within the domains of ‘public consultation’ and ‘dissemination and implementation of guidelines’.
This study found the pan-Canadian guideline for cancer-related fatigue (Howell et al., 2015) to be more appropriate for use in Australia than other international guidelines. Guideline developers should make evidence-based guidelines easier to apply to enhance their implementation.