Characteristics and Symptom Burden of Patients Accessing Acupuncture Services at a Cancer Hospital

Abstract

Background: Patients with cancer are often impacted by a significant symptom burden. Cancer hospitals increasingly recognize the value of complementary and integrative therapies to support the management of cancer related symptoms. The aim of this study is to provide a better understanding of the demographic characteristics and symptoms experienced by cancer patients who access acupuncture services in a tertiary hospital in Australia. Methods: A retrospective audit was conducted of patients that presented to the acupuncture service at Chris O’Brien Lifehouse between July 2017 and December 2018. Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCaW) outcome measures were used. The quantitative data was analyzed using descriptive statistics and Principal Component Analysis. Results: A total of 127 inpatients and outpatients (mean age 55, range 19-85) were included with 441 individual surveys completed (264 ESAS, 177 MYCaW). Patients were predominantly female (76.8%) and breast cancer was the most prevalent primary diagnosis (48%). The most prevalent symptoms in the ESAS were sleep problems (88.6%), fatigue (88.3%), lack of wellbeing (88.1%), and memory difficulty (82.6%). Similarly, symptoms with the highest mean scores were numbness, fatigue, sleep problems and hot flushes, whilst neuropathy, and hot flashes were scored as the most severe (score ≥7) by patients. Cluster analysis yielded 3 symptom clusters, 2 included “physical symptoms” (pain, sleep problems, fatigue and numbness/neuropathy), and (nausea, appetite, general well-being), whilst the third included “psychological” symptoms (anxiety, depression, spiritual pain, financial distress). The most frequent concerns expressed by patients (MyCaW) seeking acupuncture were side effects of chemotherapy (24.6%) and pain (20.8%). Conclusion: This audit highlights the most prevalent symptoms, the symptoms with the greatest burden and the types of patients that receive acupuncture services at an Australian tertiary hospital setting. The findings of this audit provide direction for future acupuncture practices and research in hospital settings.

Practice Patterns on the Incorporation of Integrative Medicine Into the Oncologic Care of Patients With Cancer

“…An interesting finding was the recommendation of mind-body therapies for patients referred for pain and an ESAS score of at least 4 for pain. 9,11,[16][17][18] Although the top 3 priorities of the providers and patients matched, we found an intriguing discrepancy between patient concerns and the reasons cited by providers for making referrals. This misalignment can be attributed to several factors that warrant further investigation.…”

“…An interesting finding was the recommendation of mind-body therapies for patients referred for pain and an ESAS score of at least 4 for pain. 9,11,16 -18…”

Thermographic evaluation of acupoints in lower limb region of individuals with osteoarthritis: A cross-sectional case-control study protocol

“…Although it is widely used, acupuncture carries a high burden for some elderly groups in many countries [32,33]. The theoretical basis and clinical effect of acupuncture in treating KOA need to be improved.…”

Acupuncture and Reflexology for Patients Undergoing Chemotherapy: A Cohort Study

“…The most prevalent symptoms in our study for those presenting for acupuncture were sleep disturbance, fatigue, and reduced appetite, and are consistent with frequently reported symptoms in other studies of cancer patients using acupuncture in a hospital setting. 17 , 18 …”

“…The most prevalent symptoms in our study for those presenting for acupuncture were sleep disturbance, fatigue, and reduced appetite, and are consistent with frequently reported symptoms in other studies of cancer patients using acupuncture in a hospital setting. 17,18 To date most studies directed at reducing the symptom burden of patients undergoing chemotherapy have focused on self-help, nurse-led intervention, psychoeducation, and cognitive behavioral therapies with mixed results. [19][20][21] Other non-pharmacological approaches specifically for symptom clusters in patients undergoing chemotherapy have included self-acupressure, and guided imagery.…”