A randomized clinical trial of energy conservation for patients with cancer‐related fatigue

Abstract

BACKGROUNDThe efficacy of energy conservation and activity management (ECAM) for fatigue reduction and maintenance of functional performance has never been evaluated in adults with cancer who are undergoing treatment.METHODSA randomized clinical trial compared an ECAM intervention with a control intervention focused on nutrition. Individuals initiating chemotherapy, radiotherapy, or concurrent therapy for cancer were randomized to receive either the semistructured ECAM intervention (n = 200) or the control intervention (n = 196). Participants in each group participated in 3 telephone sessions with an oncology nurse during the first 5 weeks of treatment. Data on fatigue and limitation of functioning were obtained before cancer treatment and at two follow‐up points that coincided with times of high fatigue for each type of treatment. The outcomes of interest included perception of fatigue and functional performance.RESULTSA repeated‐measures analysis of covariance using the type of cancer treatment as a covariate revealed a significant study group–by‐time interaction indicating that the ECAM group experienced a greater decrease in fatigue over time compared with the control group (F2,544 = 4.5; P = 0.01). The intervention was not associated with changes in overall functional performance.CONCLUSIONSIndividuals who received the ECAM intervention derived a modest but significant benefit from it. To achieve a more robust clinical benefit from the intervention, it may be necessary to manage other key symptoms in addition to fatigue. Research is needed to examine symptom clusters or combinations associated with negative outcomes as well as combination strategies for symptom management. Cancer 2004. © 2004 American Cancer Society.

Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue.

“…Twenty-four publications were categorized as psychological intervention studies (Badger et al, 2005;Barsevick et al, 2003;Boesen et al, 2005;Bordeleau et al, 2003;de Wit et al, 1997;Decker, Cline-Elsen, & Gallagher, 1992;Edelman, Bell, & Kidman, 1999;Fawzy et al, 1990;Forester, Kornfeld, & Fleiss, 1985;Gaston-Johansson et al, 2000;Goodwin et al, 2001;Hack et al, 2003;Jacobsen et al, 2002;Oyama, Kaneda, Katsumata, Akechi, & Ohsuga, 2000;Rawl et al, 2002;Sandgren & McCaul, 2003;Sandgren, McCaul, King, O'Donnell, & Foreman, 2000;Speca, Carlson, Goodey, & Angen, 2000;Spiegel, Bloom, & Yalom, 1981;Telch & Telch, 1986;Vos, Garssen, Visser, Duivenvoorden, & de Haes, 2004;Wenzel, Robinson, & Blake, 1995;Williams & Schreier, 2004;Wydra, 2001) and 17 were categorized as activity-based intervention studies (Burnham & Wilcox, 2002;Campbell, Mutrie, White, McGuire, & Kearney, 2005;Coleman et al, 2003;Courneya, Friedenreich, Sela et al, 2003;Courneya, Mackey et al, 2003;Drouin et al, 2005;Headley, Ownby, & John, 2004;McKenzie & Kalda, 2003;Mock et al, 1994Mock et al, , 1997Mock et al, 2005;Pinto, Clark, Maruyama, & Feder, 2003;…”

Integrative Nonpharmacologic Behavioral Interventions for the Management of Cancer-Related Fatigue

“…As with exercise interventions, a growing body of empiric data supports the use of psychosocial interventions for the management of CRF. Randomized, controlled clinical trials have examined a variety of psychosocial interventions in cancer survivors during and after treatment (Table 2) [139][140][141][142][143][144][145][146][147][148][149][150][151][152][153].…”

Cancer-Related Fatigue: The Approach and Treatment

“…General strategies include energy conservation and distraction 15,16 . Energy conservation consists of prioritizing and pacing activities with delegating less critical activities to others.…”