Pharmacologic Treatments for Fatigue Associated With Palliative Care

What is the best available evidence regarding pharmacologic treatments used to relieve nonspecific fatigue in people with advanced disease?
Type of Review
A systematic review of randomized controlled trials (RCTs) was conducted. Meta-analysis was performed when two or more studies of the same substance could be analyzed in a subpopulation of participants (i.e., with the same illness).
Relevance to Nursing
Fatigue is the most commonly reported symptom in individuals who have cancer and also is highly prevalent in populations with progressive life-threatening conditions. Fatigue presents a challenge for healthcare professionals because it can be nonspecific to treatment or illness, ongoing, subjective, and disabling to patients. In addition, the actual causes of fatigue are difficult to isolate, particularly in the person who is receiving palliative care because the symptom usually overlaps with concurrent disease-related problems such as malnutrition, sleep disturbances, pain, depression, asthenia, infections, and anemia. No consensus exists on the definition of fatigue or a standardized method of assessment. The working diagnosis used for the purpose of this review was “fatigue is a subjective feeling of tiredness, weakness or lack of energy” (Radbruch et al., 2008, p. 15).
In the context of palliative and advanced disease, fatigue can be viewed as an inevitable characteristic of the last phase of life. However, several pharmacologic treatments have been studied in an attempt to reduce the severity of the symptom and thereby improve the overall quality of life. Knowledge of effective medical treatments will be of particular interest to nurses who care for patients who frequently experience debilitating fatigue.