Patient Education Integrated with Acupuncture for Relief of Cancer-Related Fatigue: Randomized Controlled Feasibility Study
Michael F Johnston, Ron D Hays, Saskia K Subramanian, Robert M Elashoff, Eleanor K Axe, Jie-Jia Li, Irene Kim, Roberto B Vargas, Jihey Lee, LuGe Yang, and Ka-Kit Hui
Background: Cancer-related fatigue (CRF) is a prominent clinical problem. There are calls for multi-modal interventions.
Methods: We assessed the feasibility of delivering patient education integrated with acupuncture for relief of CRF in a pilot randomized controlled trial (RCT) with breast cancer survivors using usual care as control. Social cognitive and integrative medicine theories guided integration of patient education with acupuncture into a coherent treatment protocol. The intervention consisted of two parts. First, patients were taught to improve self-care by optimizing exercise routines, improving nutrition, implementing some additional evidence-based cognitive behavioral techniques such as stress management in four weekly 50-minute sessions. Second, patients received eight weekly 50-minute acupuncture sessions. The pre-specified primary outcome, CRF, was assessed with the Brief Fatigue Inventory (BFI). Secondary outcomes included three dimensions of cognitive impairment assessed with the FACT-COGv2.
Results: Due to difficulties in recruitment, we tried several methods that led to the development of a tailored recruitment strategy: we enlisted oncologists into the core research team and recruited patients completing treatment from oncology waiting rooms. Compared to usual care control, the intervention was associated with a 2.38-point decline in fatigue as measured by the BFI (90% Confidence Interval from 0.586 to 5.014; p<0.10). Outcomes associated with cognitive dysfunction were not statistically significant.
Conclusion: Patient education integrated with acupuncture had a very promising effect that warrants conducting a larger RCT to confirm findings. An effective recruitment strategy will be essential for the successful execution of a larger-scale trial.
Copyright © 2011 Johnston et al. This is an open access article distributed under the
Creative Commons Attribution License
3. Usual Care
4. Human Subjects
1. Patient Recruitment
2. Outcome Results
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