Distinct evening fatigue profiles in oncology outpatients receiving chemotherapy

Background: Fatigue is the most common and debilitating symptom experienced by oncology patients during chemotherapy (CTX). Fatigue severity demonstrates a large amount of inter-individual and diurnal variability. Purpose: Study purposes were to evaluate for subgroups of patients with distinct evening fatigue profiles and evaluate how these subgroups differed on demographic, clinical, and symptom characteristics. Methods: Outpatients with breast, gastrointestinal, gynecological, or lung cancer (n = 1332) completed questionnaires six times over two cycles of CTX. Lee Fatigue Scale evaluated evening fatigue severity. Latent profile analysis was used to identify distinct evening fatigue profiles. Results: Four distinct evening fatigue classes (i.e. Low (14.0%), Moderate (17.2%), High (36.0%), and Very High (32.8%)) were identified. Compared to the Low class, patients in the Very High evening fatigue class were: younger, female, had childcare responsibilities, had more years of education, had a lower functional status, had a higher comorbidity burden, and were diagnosed with breast cancer. Patients in the Very High class reported higher levels of depressive symptoms, sleep disturbance, and evening fatigue at enrollment. Conclusions: Findings provide new insights into modifiable risk factors for higher levels of evening fatigue. Clinicians can use this information to identify higher risk patients and plan appropriate interventions.