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

  • Author(s): Johnston, Michael F
  • Hays, Ron D
  • Subramanian, Saskia K
  • Elashoff, Robert M
  • Axe, Eleanor K
  • Li, Jie-Jia
  • Kim, Irene
  • Vargas, Roberto B
  • Lee, Jihey
  • Yang, LuGe
  • Hui, Ka-Kit
  • et al.
Abstract

Abstract 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. 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

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