Interventions for fatigue and weight loss in adults with advanced progressive illness

Faculty of Life and Health Sciences, University of Ulster at Jordanstown, Belfast, UK.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 01/2012; 1(1):CD008427. DOI: 10.1002/14651858.CD008427.pub2
Source: PubMed

ABSTRACT Fatigue and unintentional weight loss are two of the commonest symptoms experienced by people with advanced progressive illness and can be of great concern to those affected and of even greater concern to formal and informal caregivers. No robust information currently exists on optimal interventions to manage fatigue and/or weight loss in any advanced progressive illness. This overview presents what we know from research held within Cochrane systematic reviews on treatments to manage these symptoms in non curative illnesses such as advanced cancer, heart failure, lung failure, cystic fibrosis, multiple sclerosis, motor neuron disease, Parkinson's disease, dementia and acquired immune deficiency syndrome (AIDS). The treatment approaches for managing fatigue were pharmacological treatments including eicosapentaenoic acid (EPA), amantadine, carnitine and non pharmacological interventions including exercise and physical training, medically assisted hydration, psychosocial interventions including self management education programmes, occupational therapy and professional support services and dietary interventions including nutritional support. The treatment approaches for managing weight loss were pharmacological treatments including eicosapentaenoic acid (EPA), megestrol acetate and anabolic steroids and non pharmacological interventions including nutritional support, progressive resistive exercise and aerobic exercise. More research is required to determine which interventions help to manage these symptoms for those who are living with advanced illness. Researchers need to consider how they can reduce the variability of study design and outcome measurements to allow for meaningful comparisons across future studies.

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Available from: Cathy Payne, Aug 26, 2015
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    • "This overview reported 26 of the 27 included CDSR reviews were of a high methodological quality using the AMSTAR. However, it was difficult to assess the methodological quality of one of the included SRs because this particular SR did not have any included studies (Payne et al., 2012). In contrast, our recent overview of SRs in the area of radiation dermatitis in cancer patients demonstrated high variability in methodological quality amongst all the included SRs (Chan et al., 2012). "
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