Policy analysis of access to and reimbursement for nonpharmacologic therapies for cancer‐related fatigue

Abstract

Cancer‐related fatigue (CRF) is an important public health issue that involves millions of community‐dwelling cancer survivors. CRF is the most debilitating patient reported symptom related to cancer therapies and exacts a significant economic and social toll. It adversely impacts patients' work, social relationships, and overall quality of life. CRF prevalence ranges from 30% to 90% during therapy and often persists months and years afterwards. This policy analysis examines the problem of lack of patient access to evidence‐based nonpharmacologic CRF therapies. The authors use a five‐step process described by Teitelbaum & Wilenski (2017) to address the problem statement, identify key stakeholders, explore problem landscape, describe two viable policy options, and make a recommendation. The two policy options considered were: (a) insurer reimbursements modeled after existing cardiac rehabilitation programs and (b) health care provider incentives that incorporate the oncology care model (OCM) quality measure. Advantages and disadvantages of both options are presented. Public health nurses are uniquely positioned in their communities to advocate for these changes to improve population health.

Experiencing and responding to chronic cancer‐related fatigue: A meta‐ethnography of qualitative research

“…CCRF is often accompanied by distress, interferes with daily activities and social relationships, and limits patient's quality of life . In addition, CCRF is an important public health issue that incurs medical and societal costs …”

Analysis of the status and factors influencing physical activity in patients undergoing ovarian cancer chemotherapy

“…( 33 ) found that physical activity in patients with cancer was closely related to decreased fatigue. Fatigue is one of the most common and unmanageable symptoms in patients with cancer, with an incidence rate of 30%–99% ( 34 , 35 ). Patients with fatigue have a self-perceived depletion of energy and stamina, and decreased interest in exercise leads to reduced physical activity.…”

Cultural adaptation of the Pan-Canadian Oncology Symptom triage and remote support practice guide for cancer-related fatigue in China: Integration of traditional Chinese medicine nursing evidence

“…Estimates of CRF prevalence have been reported to range from 30% to 99%. 2 , 3 CRF affects patients' personal, social, and work lives and has profoundly negative effects on overall quality of life. 4 , 5 Despite the high prevalence of fatigue and its substantial influence on quality of life, routine screening of patients with cancer for fatigue and guidance for fatigue management has not received adequate attention in China.…”