A randomized controlled trial to evaluate the effectiveness of a brief, behaviorally oriented intervention for cancer-related fatigue.
BACKGROUND
It has been shown that nonpharmacologic interventions are effective management techniques for cancer-related fatigue (CRF) in cancer survivors. However, few studies have investigated their effectiveness in patients who are receiving chemotherapy. In this study, the authors tested the effectiveness of a brief behaviorally oriented intervention in reducing CRF and improving physical function and associated distress in individuals who were receiving chemotherapy.


METHODS
For this randomized controlled trial, 60 patients with cancer were recruited and received either usual care or the intervention. The intervention was delivered on an individual basis on 3 occasions over a period from 9 weeks to 12 weeks, and the objective of the intervention was to alter fatigue-related thoughts and behavior. Primary outcomes were assessed as follows: CRF using the Visual Analogue Scale-Global Fatigue; physical functioning using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 Questionnaire, and CRF-associated distress using the Fatigue Outcome Measure. Assessments were made on 4 occasions: at baseline (T0), at the end of chemotherapy (T1), 1 month after chemotherapy (T2), and 9 months after recruitment (T3). Normally distributed data were analyzed using t tests and random-slope/random-intercept mixed models.


RESULTS
The intervention demonstrated a trend toward improved CRF, although this effect was reduced once confounders had been controlled statistically. There was a significant improvement in physical functioning (coefficient, 10.0; 95% confidence interval, 2.5-17.5; P = .009), and this effect remained once the confounding effects of mood disturbance and comorbid disorders were controlled statistically. No decrease in fatigue-related distress was detected.


CONCLUSIONS
The behaviorally oriented intervention brought about significant improvements in physical functioning, indicated a trend toward improved CRF, but detected no effect for fatigue-related distress.
Florence Nightingale School of Nursing and Midwifery, King's College London, Waterloo Bridge Wing, Franklin Wilkins Building, Stamford Street, London, United Kingdom. jo.armes@kcl.ac.uk
Jo
J
Armes
Trudie
T
Chalder
Julia
J
Addington-Hall
Alison
A
Richardson
Matthew
M
Hotopf
D000203:Activities of Daily Living; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001521:Behavior Therapy / Q000379:methods; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005221:Fatigue / Q000139:chemically induced / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011788:Quality of Life; D016896:Treatment Outcome
D000970:Antineoplastic Agents