Patient education integrated with acupuncture for relief of cancer-related fatigue: Randomized controlled feasibility study.

Author: Johnston MF, Hays RD, Subramanian SK, Elashoff RM, Axe EK, Li JJ, Kim I, Vargas RB, Lee J, Yang L, Hui KK.
Conference/Journal: BMC Complement Altern Med.
Date published: 2011 Jun 25
Other: Volume ID: 11 , Issue ID: 1 , Pages: 49 , Word Count: 247


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 where patients were taught. 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.

CONCLUSIONS:
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. Trial registration: NCT00646633.

PMID: 21703001