The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials

Corbett, Teresa; Groarke, AnnMarie; Devane, Declan; Carr, Ewan; Walsh, Jane C.; McGuire, Brian E.

doi:10.1186/s13643-019-1230-2

Cited by 57 publications

(58 citation statements)

References 74 publications

(478 reference statements)

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“…Applying behavioural approaches may be useful because CIPN is associated with a wide range of psychosocial and secondary factors that contribute to patients' experience of CIPN symptoms, such as poor or disturbed sleep, cancer or treatment-related anxiety and unhelpful cognitive behavioural responses to CIPN symptoms, such as underreporting of symptoms to get maximum dose or acceptance that CIPN symptom severity is equivalent to treatment efficacy [4,14]. Behavioural interventions aim to influence and target behaviours, cognitions and/or emotions which perpetuate or worsen symptoms [15,16]; they have been used to improve management of cancer disease symptoms and chemotherapy side effects such as fatigue and cognitive dysfunction [17][18][19]. These interventions usually include a range of components which aim to improve knowledge, encourage people to change their behaviour and/or the way they think about or emotionally respond to their symptoms.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

et al. 2021

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Background Chemotherapy-induced peripheral neuropathy (CIPN) can result in functional difficulties. Pharmacological interventions used to prevent CIPN either show low efficacy or lack evidence to support their use and to date, duloxetine remains the only recommended treatment for painful CIPN. Non-pharmacological interventions such as exercise and behavioural interventions for CIPN exist. Purpose The aims were to (1) identify and appraise evidence on existing behavioural and exercise interventions focussed on preventing or managing CIPN symptoms, (2) describe psychological mechanisms of action by which interventions influenced CIPN symptoms, (3) determine the underpinning conceptual models that describe how an intervention may create behaviour change, (4) identify treatment components of each intervention and contextual factors, (5) determine the nature and extent of patient and clinician involvement in developing existing interventions and (6) summarise the relative efficacy or effectiveness of interventions to lessen CIPN symptoms and to improve quality of life, balance and muscle strength. Methods A systematic search of Ovid Medline, Cochrane Library, EMBASE, PsycINFO, Health Management Information Consortium, Global Health and CINAHL was performed to identify articles published between January 2000 to May 2020, followed by OpenGrey search and hand-searching of relevant journals. Studies that explored behavioural and/or exercise interventions designed to prevent or improve symptoms of CIPN in adults who had received or were receiving neurotoxic chemotherapy for any type of cancer, irrespective of when delivered within the cancer pathway were included. Results Nineteen randomised controlled trials and quasi-experimental studies which explored behavioural (n=6) and exercise (n=13) interventions were included. Four studies were rated as methodologically strong, ten were moderate and five were weak. Ten exercise and two behavioural interventions, including those that improved CIPN knowledge and self-management resources and facilitated symptom self-reporting, led to reduced CIPN symptoms during and/or after chemotherapy treatment. Conclusions The extent of potential benefits from the interventions was difficult to judge, due to study limitations. Future interventions should incorporate a clear theoretical framework and involve patients and clinicians in the development process. Implications for Cancer Survivors Our findings show exercise interventions have beneficial effects on CIPN symptoms although higher quality research is warranted. Behavioural interventions that increase patient’s CIPN knowledge, improve self-management capacity and enable timely access to symptom management led to reduced CIPN symptoms.

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Section: Introductionmentioning

confidence: 99%

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

et al. 2021

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“…In contrast to previous reports, we focused on survival outcomes, which has not been comprehensively evaluated in previous systematic reviews, and did not restrict to RCTs on specific cancer type to allow a broad overview on the effects of these interventions on cancer survival. 1 , 5 , 6 , 12 , 13 , 16 , 17 In contrast to two recent systematic reviews on physical activity, 10 , 11 our protocol was prospectively registered and no date or language restrictions were used. Despite the renewed interests on physical activity and psychological therapy for cancer survivors, we only identified 31 RCTs that have evaluated these interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous observational studies and clinical trials on physical activity and psychological interventions have been reported. Psychological interventions have been demonstrated to significantly reduce fear of cancer recurrence, 58 fatigue 16 and other patient-reported psychological outcomes. 59 These studies also suggested larger beneficial effects were associated with shorter follow-up periods, complementing our results suggesting longer-term interventions demonstrated a trend towards larger survival benefits.…”

Section: Discussionmentioning

confidence: 99%

“…15 Moreover, promoting long-term adoption of any behavioural and psychological intervention is challenging. 13 Similarly, psychological interventions have been shown to improve fatigue 16 and QoL 5 , 6 , 12 , 17 in patients with cancers, but their influence on survival outcomes have not been thoroughly investigated in different cancer types. 5 , 6 , 12 , 17 …”

Section: Introductionmentioning

confidence: 99%

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The effects of physical activity, fast-mimicking diet and psychological interventions on cancer survival: A systematic review and meta-analysis of randomized controlled trials

Clark

Maguire

Cannon

et al. 2021

Complementary Therapies in Medicine

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Highlights All RCTs on physical activity, fast-mimicking diet and psychological interventions with evaluated survival outcomes in all cancers were reviewed. Long-term psychological therapies in primary and/or adjuvant treatment settings have demonstrated potential to improve survival. The effects of fast-mimicking diet on cancer survival has not been evaluated to date. Well-designed and sufficiently powered RCTs are needed to evaluate the survival benefits of physical activities and psychological and behavioural therapies in cancer.

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“… 90 These approaches have been studied for their effects on symptoms, including pain, fatigue, and pruritus in non-CKD populations, with several studies suggesting positive effects. 91 - 93 The possibility that stress reduction techniques might be able to reduce the saliency and distress of pruritus therefore warrants further investigation in individuals with CKD. The implementation of routine, systematic symptom assessments in CKD has also been proposed as a way to address underreporting of symptoms in general, identify patients in need of intervention, and trigger more timely and consistent intervention.…”

Section: Reviewmentioning

confidence: 99%

Have We Just Scratched the Surface? A Narrative Review of Uremic Pruritus in 2020

Martín

Clotet-Freixas

Farragher

et al. 2020

Can J Kidney Health Dis

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Purpose of review: Uremic pruritus is a highly prevalent and debilitating symptom in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). The purpose of this review is to examine current evidence on the mechanisms and treatments of pruritus in CKD and highlight promising areas for future research. Sources of information: Published literature, including randomized controlled trials, cohort studies, case reports, and review articles, was searched for evidence pertaining to the pathophysiology and treatment of uremic pruritus. Methods: A comprehensive narrative review was conducted to explore the molecular mechanisms underlying uremic pruritus, as well as the evidence (or lack thereof) supporting pharmacological and nonpharmacological treatments for uremic pruritus. The potential role of patient sex in the pathophysiology and management of uremic pruritus is also discussed. Key findings: The pathophysiology of uremic pruritus involves a complex interplay of uremic toxins, systemic inflammation, mast cell activation, and imbalance of opioid receptors. Classic treatment strategies for uremic pruritus include optimization of dialysis parameters, amelioration of CKD-related mineral and bone disease, topical emollients and analgesics, antihistamines, the anticonvulsant medications gabapentin and pregabalin, and ultraviolet light B (UV-B) phototherapy. Strong data to support many of these classical treatments for uremic pruritus are limited. Newly evolving treatment approaches for uremic pruritus include opioid receptor modulators, neurokinin-1 inhibitors, and cannabinoids. Further studies regarding their efficacy, pharmacodynamics, and safety in the CKD and ESKD population are needed before these agents are accepted into widespread use. Additional nonpharmacological strategies aimed at treating uremic pruritus include psychotherapy, acupuncture, omega-3 fatty acids, and exercise. Finally, sex differences may exist regarding uremic pruritus, but studies directly addressing sex-specific mechanisms of uremic pruritus remain absent. Limitations: High-quality evidence in the management of uremic pruritus remains lacking. Most recommendations are based on expert opinion or studies involving small numbers of patients. In addition, our understanding of the pathophysiological mechanisms behind uremic pruritus is incomplete and continues to evolve over time. Implications: Uremic pruritus is a common symptom which reduces quality of life in CKD and ESKD. The identification of novel targeted treatment approaches may ease the burden of uremic pruritus in the future.

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The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials

Cited by 57 publications

References 74 publications

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms

The effects of physical activity, fast-mimicking diet and psychological interventions on cancer survival: A systematic review and meta-analysis of randomized controlled trials

Have We Just Scratched the Surface? A Narrative Review of Uremic Pruritus in 2020

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