Management of cancer-related fatigue during chemotherapy through telephone motivational interviewing: modeling and randomized exploratory trial

Abstract

Objective: Fatigue is a common cancer-related symptom and exacerbated by chemotherapy. Psychological interventions for fatigue show promise. One, Beating Fatigue, was adapted for delivery by telephone and evaluated in an exploratory trial.

Methods: Eight patients and 12 professionals contributed to focus groups that guided adaptation of the intervention. The intervention, modified for delivery by telephone using motivational interviewing, was tested in an exploratory trial. Forty-four patients were recruited to the trial and randomized between the intervention (n=23) and control (n=21). Outcome data were collected on fatigue intensity, fatigue distress, fatigue self-efficacy, anxiety and depression at baseline and following completion of chemotherapy. These data were augmented by interviews conducted to inform understanding of the intervention's mechanism, feasibility and acceptability.

Results: The intervention was both feasible and acceptable to patients and most reduced fatigue distress (Effect Size ES=0.62). It also reduced fatigue intensity (ES=0.18), fatigue self-efficacy (ES=-0.34), and anxiety (ES=0.31). It did not reduce depression.

Conclusion: These preliminary data are encouraging and support the delivery of interventions for cancer-related fatigue by telephone. Motivational interviewing appeared key to the intervention's success. A larger definitive RCT is indicated.

Practice implications: Opportunities should be sought to deliver psychologically-based interventions for fatigue by telephone.

Keywords: Cancer; Chemotherapy; Fatigue; Motivational interviewing; Psychological intervention; Telephone intervention.