Introduction The Occupational Therapy team were invited to contribute to the development of a therapeutic out-patient programme within the hospice. It was agreed that this would take the form of a fatigue management group. Following completion of two consecutive group programmes the data was analysed and resulted in changing to an individual programme. This presentation outlines the development and review of the two programmes.

Aims Fatigue in advanced cancer is very common, being experienced by the majority of palliative care patients, causing significant impact on function and quality of life.

The aim of the programme was to provide patients with the opportunity to:

• learn how to manage the symptom of fatigue

• enhance their self-confidence in the management of fatigue

• share their experiences

• create support networks

Methods The initial programme was designed to be a closed group of six patients, meeting once weekly for four sessions. Following two courses the intervention was reviewed. Subsequently, the programme was changed to an individual course of two sessions at fortnightly intervals plus a review session.

Results Evaluation of the group programme showed that whilst the patients enjoyed the sessions and the social interaction, it had little impact on improving fatigue, attendance was poor and the programme was very demanding on therapist time.

The individual programme however, demonstrated a greater improvement in fatigue with the ability to offer individualised advice and increased flexibility. Attendance was improved and it has proved more time efficient for staff.

Conclusion Fatigue management is traditionally offered as a group programme within palliative care. However, a review of two programmes offered within a hospice out-patient setting demonstrated that an individual programme was more effective. These findings may be beneficial to other services considering setting up a similar programme.