OP21ASSESSING ASSOCIATED SYMPTOMS OF FATIGUE: TRIALLING A ‘SYMPTOMS MDM’ IN EDINBURGH FOR PRIMARY BRAIN TUMOUR

INTRODUCTION: Fatigue is unusual daytime tiredness not relieved by sleep. It is common and with mixed aetiology in glioma. Annual fatigue assessment in stable patients with glioma is being trialled through a ‘symptoms MDM’ METHOD: Patients aged >18years, diagnosed with a glioma that was clinically stable, and had completed a fatigue study, were offered further clinical evaluation of their results by discussion at a ‘symptoms MDM’. This included a neurologist, clinical psychologist, psychiatrist and sleep consultant. Assessments included self-reported fatigue, mood, cognition, a growth hormone questionnaire, full neurological examination, and 2 week sleep assessment using an Actigraphy Watch and sleep log. RESULTS: 37/50 patients requested further assessment, including 10/10 severely fatigued, 22/24 moderately fatigued, 4/8 mildly fatigued and 1/8 non-fatigued. Of these the HADS depicted 20 patients with abnormal anxiety (8 borderline) and 5 with abnormal depression (11 borderline), 36 had poor cognition in one or more areas, and a sleep consultant reviewed 23 with abnormal sleep.Individual intervention plans included combinations of: referrals to clinical psychology (10), psychiatry (2), endocrinology (17), sleep clinic (5) and anti-epileptic medication review (9). Twelve were offered local support group in formation, and 24 were offered self-guided relaxation and sleep hygiene information. Almost all patients agreed to all interventions; 1 declined clinical psychology referral, 3 declined anti-epileptic review due to regaining a driving licence. CONCLUSION: Fatigue in glioma is common, complex and debilitating, but may be helped by managing symptoms, through annual ‘symptoms MDM’ and individualised treatment plans.