title: A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture.
abstract: BACKGROUND
  Maintenance acupuncture is advocated by clinicians after successful clinic-based acupuncture. We aimed to assess the effectiveness of maintenance acupuncture in the management of cancer-related fatigue (CRF); treatment delivered by therapists or self-acupuncture/self-needling was compared with no maintenance treatment.
  
  
  METHODS
  Breast cancer patients who participated in a randomized trial of acupuncture for CRF management (reported elsewhere) were re-randomized to receive an additional four acupuncturist-delivered weekly sessions; four self-administered weekly acupuncture sessions (self-needling); or no acupuncture. Primary outcome was general fatigue (Multidimensional Fatigue Inventory). Mood, quality of life and safety were also assessed.
  
  
  RESULTS
  In total, 197 patients were re-randomized, with 65 to therapist-delivered sessions, 67 to self-acupuncture/self-needling and 65 to no further acupuncture. Primary outcome scores were equivalent between the therapist-delivered acupuncture and self-acupuncture (P > 0.05). A non-significant trend in improving fatigue was observed at the end of 4 weeks in the combined acupuncture arms (P = 0.07). There was no impact on mood or quality of life of the further acupuncture sessions at 18 weeks beyond the improvement observed in initial trial.
  
  
  CONCLUSIONS
  Self-acupuncture is an acceptable, feasible and safe maintenance treatment for patients with CRF. However, overall, maintenance acupuncture did not yield important improvements beyond those observed after an initial clinic-based course of acupuncture.
  
  
  BACKGROUND
  NCT00957112.
authors: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. alex.molassiotis@manchester.ac.uk
authors: A
authors: A
authors: Molassiotis
authors: J
authors: J
authors: Bardy
authors: J
authors: J
authors: Finnegan-John
authors: P
authors: P
authors: Mackereth
authors: W D
authors: WD
authors: Ryder
authors: J
authors: J
authors: Filshie
authors: E
authors: E
authors: Ream
authors: D
authors: D
authors: Eaton
authors: A
authors: A
authors: Richardson
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods* / Q000592:standards; D005221:Fatigue / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006282:Health Personnel / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000592:standards; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D012648:Self Care / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
keywords: acupuncture; breast cancer; fatigue; maintenance treatment; self-acupuncture; self-needling