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17.05.2016 | Original Article

Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors

verfasst von: Shelley A. Johns, Linda F. Brown, Kathleen Beck-Coon, Tasneem L. Talib, Patrick O. Monahan, R. Brian Giesler, Yan Tong, Laura Wilhelm, Janet S. Carpenter, Diane Von Ah, Christina D. Wagner, Mary de Groot, Karen Schmidt, Diane Monceski, Marie Danh, Jennifer M. Alyea, Kathy D. Miller, Kurt Kroenke

Erschienen in: Supportive Care in Cancer | Ausgabe 10/2016

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Abstract

Purpose

Cancer-related fatigue (CRF) is a disruptive symptom for many survivors. Despite promising evidence for efficacy of mindfulness-based stress reduction (MBSR) in reducing CRF, no trials comparing it to an active comparator for fatigued survivors have been published. The purpose of this trial was to compare MBSR to psychoeducation for CRF and associated symptoms.

Methods

Breast (n = 60) and colorectal (n = 11) cancer survivors (stage 0–III) with clinically significant CRF after completing chemotherapy and/or radiation therapy an average of 28 months prior to enrollment were randomized to MBSR or psychoeducation/support groups (PES). MBSR focused on mindfulness training; PES focused on CRF self-management. Outcomes included CRF interference (primary), CRF severity and global improvement, vitality, depression, anxiety, sleep disturbance, and pain. Outcomes were assessed at baseline (T1), post-intervention (T2), and 6-month follow-up (T3) using intent-to-treat analysis.

Results

Between-group differences in CRF interference were not significant at any time point; however, there was a trend favoring MBSR (d = −0.46, p = 0.073) at T2. MBSR participants reported significantly greater improvement in vitality (d = 0.53, p = 0.003) and were more likely to report CRF as moderately to completely improved compared to the PES group (χ2 (1) = 4.1765, p = 0.041) at T2. MBSR participants also reported significantly greater reductions in pain at T2 (d = 0.53, p = 0.014). In addition, both MBSR and PES produced moderate-to-large and significant within-group improvements in all fatigue outcomes, depression, anxiety, and sleep at T2 and T3 compared to T1.

Conclusion

MBSR and PES appear efficacious for CRF and related symptoms. Larger trials including a usual care arm are warranted.

Trial Registration

ClinicalTrials.gov Identifier: NCT01724333.

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Titel: Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors
verfasst von: Shelley A. Johns
Linda F. Brown
Kathleen Beck-Coon
Tasneem L. Talib
Patrick O. Monahan
R. Brian Giesler
Yan Tong
Laura Wilhelm
Janet S. Carpenter
Diane Von Ah
Christina D. Wagner
Mary de Groot
Karen Schmidt
Diane Monceski
Marie Danh
Jennifer M. Alyea
Kathy D. Miller
Kurt Kroenke
Publikationsdatum: 17.05.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 10/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3220-4

Springer Medizin

Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors