title: Patient education integrated with acupuncture for relief of cancer-related fatigue randomized controlled feasibility study.
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.
  
  
  BACKGROUND
  NCT00646633.
authors.affiliation: UCLA Center for East-West Medicine, David Geffen School of Medicine at UCLA, LA, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Johnston
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
authors.forename: Saskia K
authors.initials: SK
authors.lastname: Subramanian
authors.forename: Robert M
authors.initials: RM
authors.lastname: Elashoff
authors.forename: Eleanor K
authors.initials: EK
authors.lastname: Axe
authors.forename: Jie-Jia
authors.initials: JJ
authors.lastname: Li
authors.forename: Irene
authors.initials: I
authors.lastname: Kim
authors.forename: Roberto B
authors.initials: RB
authors.lastname: Vargas
authors.forename: Jihey
authors.initials: J
authors.lastname: Lee
authors.forename: LuGe
authors.initials: L
authors.lastname: Yang
authors.forename: Ka-Kit
authors.initials: KK
authors.lastname: Hui
mesh_terms: D015670:Acupuncture Therapy; D001943:Breast Neoplasms / Q000150:complications*; D003072:Cognition Disorders; D004032:Diet; D005069:Evaluation Studies as Topic; D015444:Exercise; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D055048:Integrative Medicine; D008875:Middle Aged; D010353:Patient Education as Topic; D012064:Relaxation Therapy; D012648:Self Care