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Table 1 CAPO recommendations for the management of CRF in adults [8]

From: Cancer related fatigue: implementing guidelines for optimal management

1. Screen for the presence of cancer related fatigue at specified times or as clinically indicated using a valid quantitative measure
2. If screened positive for fatigue (Score > 2 on a 0–10 numeric rating scale), complete a focused assessment of fatigue and possible medical causes
3. Treat contributing factors and/or refer for further specialist evaluation
4. Evidence is insufficient to recommend pharmacological agents for fatigue at any stage of disease
5. Counsel all patients as is safe to engage in moderate-intensity physical activity for at least 30 min on five or more days of the week
6. All types of physical activity at lower intensity (e.g. walking, yoga) may contribute to decreasing fatigue during and after active cancer treatment
7. All patients are likely to benefit from routine patient education about fatigue self-management
8. Cancer services should promote access to multi-component, group psycho-education programs targeted to self management
9. Referral to experts or fatigue clinics that are trained in cognitive behavioural therapy targeted to fatigue should be offered to patients and survivors with chronic cancer fatigue
10. There is insufficient evidence to advise seeking herbal medicines or acupuncture for treatment of fatigue. Herbal products should be used with caution and patients should discuss their use with the oncology team
11. There is preliminary evidence that mindfulness-based interventions are likely to improve fatigue