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approaches are also helpful. Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation of the joints. It’s the second most common type of arthritis in the UK population. Key symptoms are painful, swollen joints, but fatigue (extreme mental and/or physical tiredness) is also a problem for many people who have RA. There’s currently no cure for RA and no accepted evidence-based guidelines on how best to manage this condition. Non-pharmacological interventions, that’s alternatives (...) What’s the evidence on tackling fatigue in rheumatoid arthritis? What’s the evidence on tackling fatigue in rheumatoid arthritis? | Evidently Cochrane sharing the latest Cochrane Reviews Search Main menu Post navigation by Key message: There is some evidence that physical activity and talking treatments can help people with rheumatoid arthritis manage fatigue. We don’t have enough evidence to say which elements of these types of interventions are most effective, nor whether other non-drug
A pragmatic parallel arm multi-centre randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based fatigue management programme (FACETS) for people with multiple sclerosis Fatigue is a common and troubling symptom for people with multiple sclerosis (MS).To evaluate the effectiveness and cost-effectiveness of a six-session group-based programme for managing MS-fatigue (Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle (...) (FACETS)).Three-centre parallel arm randomised controlled trial with economic evaluation. Patients with MS and significant fatigue were randomised to FACETS plus current local practice (FACETS) or current local practice alone (CLP), using concealed computer-generated randomisation. Participant blinding was not possible. Primary outcomes were fatigue severity (Fatigue Assessment Instrument), self-efficacy (Multiple Sclerosis-Fatigue Self-Efficacy) and disease-specific quality of life (Multiple
Nonpharmacological nursing interventions for the management of patient fatigue: a literature review To identify and describe nonpharmacological interventions for the management of fatigue that are within the scope of nursing practice.Fatigue is a complex multidimensional symptom experienced by patients with varying diagnoses. Limited details are available on the nature of nursing interventions to manage fatigue, which preclude fidelity of implementation in day-to-day practice.Literature (...) review.Multiple databases were searched for publications reporting on the evaluation of nurse-delivered interventions for the management of fatigue. Data were extracted on study and intervention characteristics and results pertaining to the effects of the intervention on fatigue.The studies (n = 16) evaluated eight interventions: psycho-education, cognitive behavioural therapy, exercise, acupressure, relaxation, distraction, energy conservation and activity management, and a combination of exercise, education
Group exercise training for balance, functional status, spasticity, fatigue and quality of life in multiple sclerosis: a randomized controlled trial To determine the effectiveness of group exercise training on balance, functional status, spasticity, fatigue and quality of life in patients with multiple sclerosis.A randomized single-blind controlled study.University hospital, outpatient physical therapy department.Ambulatory patients with multiple sclerosis.Exercise group completed a 12-week (...) group exercise programme under the physical therapists' supervision. Control group was included in the waiting list.The primary outcome measures were the Berg Balance Scale, 10-metre walk test, 10-steps climbing test and secondary outcome measures were the Modified Ashworth Scale, Fatigue Severity Scale and Multiple Sclerosis International Quality of Life.Ninety-nine patients completed the study. There were statistically significant improvements for all outcome measures in the group exercise group
Internet-Based Therapy for Adolescents With Chronic Fatigue Syndrome: Long-term Follow-up Cognitive behavioral therapy (CBT) is known to be an effective treatment of adolescents with chronic fatigue syndrome (CFS), but its availability is limited. Fatigue in Teenagers on the Internet (FITNET), an Internet-based CBT program for adolescents with CFS, has been developed as an alternative to face-to-face CBT. Recently, its short-term effectiveness has been proven in a randomized clinical trial (...) . Here we aimed to assess the long-term outcome of CFS in adolescents after FITNET treatment and after usual care. In addition, factors related to recovery at long-term follow-up (LTFU) for adolescents treated with the FITNET program were investigated.The study was an LTFU of participants of the FITNET trial. Data were completed for 112 (88.2%) of 127 approached FITNET study participants. Primary outcomes were fatigue severity (Checklist Individual Strength-20), physical functioning (87-item Child
Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis McCrone P, Sharpe M, Chalder T, Knapp M (...) medical care for patients with chronic fatigue syndrome in the UK. The authors concluded that CBT had the highest probability of being the most cost-effective treatment option. The methodology of the study was reported appropriately and clearly. The authors' conclusions appear appropriate, although they may be limited by the short time frame. Type of economic evaluation Cost-effectiveness analysis, cost-utility analysis Study objective The study compared the cost-effectiveness of adding adaptive
A pilot randomised controlled trial of an internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Systematic Monitoring and Treatment of Physical Symptoms to Alleviate Fatigue in Patients With Advanced Cancer: A Randomized Controlled Trial Several guidelines on the treatment of cancer-related fatigue recommend optimizing treatment of accompanying symptoms. However, evidence for this recommendation from randomized clinical trials is lacking. We investigated whether monitoring and protocolized treatment of physical symptoms alleviates fatigue.In all, 152 fatigued patients with advanced cancer (...) were randomly assigned to protocolized patient-tailored treatment (PPT) of symptoms or care as usual. The PPT group had four appointments with a nurse who assessed nine symptoms on a 0 to 10 numeric rating scale (NRS). Patients received a nonpharmacologic intervention for symptoms with a score ≥ 1 and a medical intervention for symptoms with a score ≥ 4. Fatigue dimensions, fatigue NRS score, interference of fatigue with daily life, symptom burden, quality of life, anxiety, and depression were
Fatigue in multiple sclerosis: modafinil Fatigue in multiple sclerosis: modafinil Fatigue in multiple sclerosis: modafinil Evidence summary Published: 2 April 2013 nice.org.uk/guidance/esuom9 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in April 2013. See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA or NICE websites for up- to-date information. Modafinil is an oral (...) 'wakefulness-promoting' agent that is licensed in the UK for treating excessive sleepiness associated with narcolepsy with or without cataplexy. Modafinil is not licensed for treating fatigue in multiple sclerosis (MS), and therefore this is an off- label use of this medication. Two small placebo-controlled randomised controlled trials (RCTs) did not find any statistically significant evidence that modafinil (up to 200 mg or 400 mg daily in the respective trials) improved fatigue in adults with MS (of any
Poststroke fatigue following minor infarcts: a prospective study To explore the potential relationship between fatigue following strokes and poststroke mood, cognitive dysfunction, disability, and infarct site and to determine the predictive factors in the development of poststroke fatigue (PSF) following minor infarcts.Ninety-nine functionally active patients aged less than 70 years with a first, nondisabling stroke (NIH Stroke Scale score ≤6 in acute phase and ≤3 after 6 months, modified (...) Rankin Scale score ≤1 at 6 months) were assessed during the acute phase and then at 6 (T1) and 12 months (T2) after their stroke. Scores in the Fatigue Assessment Inventory were described and correlated to age, gender, neurologic and functional impairment, lesion site, mood scores, neuropsychological data, laboratory data, and quality of life at T1 and T2 using a multivariate logistic regression analysis in order to determine which variables recorded at T1 best predicted fatigue at T2.As many as 30.5
Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial We aimed to assess the effectiveness of acupuncture for cancer-related fatigue (CRF) in patients with breast cancer.We conducted a pragmatic, randomized controlled trial comparing acupuncture with enhanced usual care. Three hundred two outpatients with breast cancer participated. We randomly assigned 75 patients to usual care and 227 patients to acupuncture plus usual care (random (...) assignment of 1:3 respectively) with minimization controlling for baseline general fatigue and maintenance treatment. Treatment was delivered by acupuncturists once a week for 6 weeks through needling three pairs of acupoints. The usual care group received a booklet with information about fatigue and its management. Primary outcome was general fatigue at 6 weeks, measured with the Multidimensional Fatigue Inventory (MFI). Other measurements included the Hospital Anxiety and Depression Scale, Functional
Modafinil for sleep disorders and fatigue secondary to multiple sclerosis: a review of the clinical efficacy and safety Modafinil for sleep disorders and fatigue secondary to multiple sclerosis: a review of the clinical efficacy and safety Modafinil for sleep disorders and fatigue secondary to multiple sclerosis: a review of the clinical efficacy and safety CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation CADTH. Modafinil for sleep disorders and fatigue secondary to multiple sclerosis: a review of the clinical efficacy and safety . Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). 2012 Authors' conclusions No conclusions can be drawn on the efficacy of modafinil compared to methylphenidate or amphetamines due to the absence of head-to-head clinical trials. Relative to placebo, modafinil was associated
Modafinil for Sleep Disorders and Fatigue Secondary to Multiple Sclerosis: A Review of the Clinical Efficacy and Safety Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources and a summary of the best evidence on the topic that CADTH could identify using all reasonable (...) , provided that attribution is given to CADTH. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: Modafinil for Sleep Disorders and Fatigue Secondary to Multiple Sclerosis: A Review of the Clinical Efficacy and Safety DATE: 27 July 2012 CONTEXT AND POLICY ISSUES Modafinil is a central nervous
Cognitive and graded activity training can alleviate persistent fatigue after stroke: a randomized, controlled trial Fatigue is a common, persistent consequence of stroke, and no evidence-based treatments are currently available to alleviate fatigue. A new treatment combining cognitive therapy (CO) with graded activity training (GRAT), called COGRAT, was developed to alleviate fatigue and fatigue-related symptoms. This study compared the effectiveness of the COGRAT intervention with a CO-only (...) intervention after a 3-month qualification period without intervention.This randomized, controlled, assessor-blind clinical trial was conducted in 8 rehabilitation centers. Eighty-three stroke patients (>4 months after stroke) were randomly assigned to 12 weeks of CO or COGRAT after qualification. Seventy-three patients completed treatment and 68 were available at follow-up. Primary outcomes (Checklist Individual Strength-subscale Fatigue (CIS-f); self-observation list-fatigue (SOL-f)) and secondary
Carnitine for fatigue in multiple sclerosis. Fatigue is reported to occur in up to 92% of patients with multiple sclerosis (MS) and has been described as the most debilitating of all MS symptoms by 28% to 40% of MS patients.To assess whether carnitine (enteral or intravenous) supplementation can improve the quality of life and reduce the symptoms of fatigue in patients with MS-related fatigue and to identify any adverse effects of carnitine when used for this purpose.A literature search (...) and a manufacturer (Source Naturals, United States) of carnitine formulation was contacted to determine if they knew of other clinical trials. No language restrictions were applied.Full reports of published and unpublished randomized controlled trials and quasi-randomized trials of any carnitine intervention in adults affected by multiple sclerosis with a clinical diagnosis of fatigue associated with multiple sclerosis were included.Data from the eligible trials was extracted and coded using a standardized data
A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients As patients with pancreas and periampullary cancer (PPC) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer (...) patients.One hundred two patients with resected PPC consented to participate in this study and were randomized to either an intervention group (IG) or a usual care group (UCG). Subjects completed visual analog scales, the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge.Patients in the IG and UCG were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, preoperative fatigue and pain levels, adjuvant
lead to compassion fatigue. 6 Anecdotes: Two members of the working group provided the following reflections on their work: In a perfect world, (the birth of a child) would be the happiest time for parents; however, we rarely see this in our jobs. The majority of the families we see are dealing with too many crises to see this as a happy time. (Reflection by a Family Visitor) Visiting complex clients in their homes can be emotionally exhausting, overwhelming, isolating and unpredictable. We can (...) Supporting Staff at Risk for Compassion Fatigue Supporting Staff at Risk for Compassion Fatigue Prepared for Region of Peel Public Health Elizabeth Walker, RN BScN, CCHN(C) Cheryl Morin, RN, BScN Nicole Labrie, RN, BScN, CCHN(C) October 1, 2012 ii Table of Contents Key Take Home Messages 1 Executive Summary 2 1 Issue 5 2 Context 7 3 Literature Search 11 4 Applicability and Transferability 19 5 Recommendations 24 References 26 Appendices 27 Appendix A: Concept Model 28 Appendix B: Search