Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

When guidelines don’t guide: Increasing applicability for guidelines for CRF (#348)

Carol McKinstry 1 , Meg Morris 2 , Elizabeth Pearson 2
  1. La Trobe University, Bendigo
  2. La Trobe University, Melbourne


Researchers have suggested that improving guideline quality could be a relatively inexpensive way to increase their use. While the rigor of evidence review is often high, published results of cancer-related fatigue (CRF) guideline appraisals reported low applicability scores for all five guidelines. This investigation aimed to identify ways to optimise the characteristics of CRF guidelines to enhance their applicability.


Health professionals, managers and cancer survivors participated in two iterative surveys using a Delphi design. Consensus was pre-determined as 75% agreement. The surveys explored participant experiences with, and perceived feasibility of, recommendations of a 254-page Canadian Association of Psychosocial Oncology (CAPO) guideline for CRF. Data types were analysed separately then merged. This report focuses on guideline characteristics.


Forty-five health professionals and managers, and 68 cancer survivors completed surveys. The CAPO guideline was highly endorsed, but many health professionals and managers considered that the level of detail in the guideline recommendations limited its use. While some thought the layout and presentation of the CAPO guideline was too long and complex for optimal clinical utility, others expressed the need for more operational details about what to do. Consensus was achieved for 13 statements related to improving guideline presentation and content. A simple layout including diagrams was favoured, with links and appendices to provide further details. Health professionals agreed on the need for further resources to support clinical application, such as patient education materials, assessment and reporting forms and tailoring options. Consumers highly endorsed a lay language guideline version and patient education materials at different levels of detail, tailored according to fatigue intensity.


Revising the CAPO guideline layout and development of implementation resources may increase its utility for clinicians and consumers. Modification to guideline characteristics is needed prior to implementation.