Toward a better understanding of the uptake of interventions for cancer-related fatigue: the perspective of healthcare providers, patients, and partners

Purpose: While cancer-related fatigue (CRF) is prevalent among cancer patients posttreatment, the uptake of evidence-based interventions is low. This suggests resources are not well used, and patient needs go unaddressed. We investigated reasons for the discrepancy between the high prevalence of CRF and limited uptake of interventions, from the perspective of healthcare providers (HCPs), patients, and partners. We explored this from experiencing CRF, to needing care, seeking care, and use of care for CRF. Methods: Semi-structured interviews and focus groups were conducted with patients (n = 16) who completed curative cancer treatment and experienced CRF, partners (n = 11), and HCPs (n = 29). Results: Thematic analysis revealed five themes explaining the low uptake of care. Only patients who experienced (1) interference due to fatigue developed a care need. Care seeking and referral to care were hampered as it was (2) unclear which HCP is responsible for assessment and management of posttreatment fatigue, and because of (3) a lack of awareness of interventions and referral pathways, (4) unhelpful expectations regarding fatigue and interventions, and (5) practical barriers influencing the initiation and continuation of care use. Conclusion: CRF posttreatment is not routinely assessed, and it is unclear for patients and HCPs which HCP is responsible for its assessment and management. Knowledge of CRF and interventions is limited, leading to uncertainty about the treatability of CRF. To improve patients’ access to care, responsibilities of HCPs need to be defined, knowledge needs to be improved, and CRF assessment and management must be integrated into standard clinical practice.