title: Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy.
abstract: OBJECTIVE
  To describe a randomized trial of a cognitive behavioral intervention on reducing symptom severity among patients diagnosed with solid tumors and undergoing a first course of chemotherapy and to determine whether the intervention had an additive or interactive effect on symptom severity in the presence of supportive care medications.
  
  
  METHODS
  Patients (N = 237) were accrued from comprehensive and community cancer centers, interviewed, and randomly assigned to either the experimental intervention (n = 118) or conventional care (n = 119). A symptom severity index, based on summed severity scores across 15 symptoms, was the primary outcome. Each patient's site of cancer, stage at diagnosis, chemotherapy protocols, and use of supportive medications were learned from medical records.
  
  
  RESULTS
  Groups were equivalent at baseline, and attrition by characteristics by group was not different. The proportion of patients not receiving chemotherapy at 10 and 20 weeks did not differ by group. At the 10- and 20-week observations, there was a significant interaction between the experimental group and baseline symptom severity. Patients in the experimental group who entered the trial with higher symptom severity reported significantly lower severity at 10 and 20 weeks. Controlling for chemotherapy treatment status at follow-up and supportive care medications did not alter the effect of the experimental intervention.
  
  
  CONCLUSIONS
  Compared with conventional care alone, the experimental intervention was effective among patients who entered the trial with higher levels of symptom severity. Age, sex, site or stage of cancer, and supportive medications did not modify the effect of this cognitive behavioral intervention on symptom severity.
authors.affiliation: Department of Family Practice, College of Human Medicine, Michigan State University, B108 Clinical Center, East Lansing, MI 48824, USA. givenc@msu.edu
authors.forename: Charles
authors.initials: C
authors.lastname: Given
authors.forename: Barbara
authors.initials: B
authors.lastname: Given
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rahbar
authors.forename: Sangchoon
authors.initials: S
authors.lastname: Jeon
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.forename: Bernadine
authors.initials: B
authors.lastname: Cimprich
authors.forename: Andrzej
authors.initials: A
authors.lastname: Galecki
authors.forename: Sharon
authors.initials: S
authors.lastname: Kozachik
authors.forename: Albert
authors.initials: A
authors.lastname: Brady
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Fisher-Malloy
authors.forename: Kathy
authors.initials: K
authors.lastname: Courtney
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bowie
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002173:Cancer Care Facilities; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003376:Counseling; D005221:Fatigue / Q000139:chemically induced / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D009859:Oncology Nursing; D010146:Pain / Q000139:chemically induced / Q000523:psychology; D059408:Pain Management; D012648:Self Care; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents