The level of distress from fatigue reported in the final two months of life by a palliative care population; An Australian national prospective, consecutive case series.

Elsevier BV
Publication Type:
Journal Article
Journal of pain and symptom management, 2020
Issue Date:
Full metadata record
CONTEXT:Fatigue is the most commonly reported symptom in life-limiting illnesses, though not much is known about the distress it causes patients as they approach death. OBJECTIVES:To map the trajectory of distress from fatigue reported by an Australian palliative care population in the last 60 days leading up to death. METHODS:A prospective, longitudinal, consecutive cohort study using national data from the Australian Palliative Care Outcomes Collaboration between 1 July 2013 and 31 December 2018. Patients were included if they had at least one measurement of fatigue on a 0-10 numerical rating scale in the 60 days before death. Descriptive statistics were used to analyse patients by diagnostic cohort and functional status. RESULTS:A total of 116,604 patients from 203 specialist palliative care services were analysed, providing 501,104 data points. Distress from fatigue affected up to 80% of patients referred to palliative care, with the majority experiencing moderate or severe distress. Malignant and non-malignant diagnoses were equally affected, with the neurological cohort showing the greatest variability. The degree of distress correlated with a patient's functional level; it worsened as a patient's function declined until a patient became bedbound when the reporting of distress reduced. CONCLUSIONS:Distress from fatigue is high in this cohort of patients. Interventions to reduce this distress need to be a research priority.
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