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Background: Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research.
Methods: PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively.
Results: Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams' Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported.
Conclusions: Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.
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http://dx.doi.org/10.1186/s12885-021-08394-3 | DOI Listing |
Pharmacoeconomics
September 2025
Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden.
Background: Immune checkpoint inhibitors (ICIs) are clinically beneficial but associated with high costs that represent a growing challenge for healthcare budgets and may affect affordability, especially in resource-limited settings. Moreover, the healthcare sector is a significant source of greenhouse gas emissions, and medication-related waste-such as that from vial-based therapies-has been identified as a contributing factor. Alternative dosing strategies could reduce the environmental and financial impact of ICI therapy while maintaining clinical safety and efficacy.
View Article and Find Full Text PDFDiabetologia
September 2025
Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
This review article, developed by the EASD Global Council, addresses the growing global challenges in diabetes research and care, highlighting the rising prevalence of diabetes, the increasing complexity of its management and the need for a coordinated international response. With regard to research, disparities in funding and infrastructure between high-income countries and low- and middle-income countries (LMICs) are discussed. The under-representation of LMIC populations in clinical trials, challenges in conducting large-scale research projects, and the ethical and legal complexities of artificial intelligence integration are also considered as specific issues.
View Article and Find Full Text PDFPediatr Surg Int
September 2025
Department of Urology Children's Hospital, Chongqing Medical University, Room 806, Kejiao Building (NO.6), No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China.
Cryptorchidism is one of the most common reproductive malformations in children, and the timing of surgery significantly impacts fertility and the risk of testicular cancer. Although international guidelines currently recommend testicular fixation within 6-18 months to improve prognosis, many children worldwide undergo surgery later than the recommended age. Delays in surgery are particularly significant in developing countries.
View Article and Find Full Text PDFSpiritual interventions, including meditation, prayer, mindfulness, and compassionate care, have gained increasing attention for their potential to enhance both psychological resilience and overall health. This systematic review and meta-analysis examined eight eligible studies conducted across the USA, Europe, and China to assess the impact of such interventions on key outcomes, namely anxiety reduction, quality of life, chronic disease symptom management, and patient satisfaction. Seven studies contributed quantitative data.
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