Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the “Fitter na kanker” Randomized Controlled Trial

Abstract

BackgroundApproximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue (CCRF). Effective and easily accessible interventions are needed for these patients.ObjectiveThe current paper reports on the results of a 3-armed randomized controlled trial investigating the clinical effectiveness of two different guided Web-based interventions for reducing CCRF compared to an active control condition.MethodsSeverely fatigued cancer survivors were recruited via online and offline channels, and self-registered on an open-access website. After eligibility checks, 167 participants were randomized via an embedded automated randomization function into: (1) physiotherapist-guided Ambulant Activity Feedback (AAF) therapy encompassing the use of an accelerometer (n=62); (2) psychologist-guided Web-based mindfulness-based cognitive therapy (eMBCT; n=55); or (3) an unguided active control condition receiving psycho-educational emails (n=50). All interventions lasted nine weeks. Fatigue severity was self-assessed using the Checklist Individual Strength - Fatigue Severity subscale (primary outcome) six times from baseline (T0b) to six months (T2). Mental health was self-assessed three times using the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule (secondary outcome). Treatment dropout was investigated.ResultsMultiple group latent growth curve analysis, corrected for individual time between assessments, showed that fatigue severity decreased significantly more in the AAF and eMBCT groups compared to the psycho-educational group. The analyses were checked by a researcher who was blind to allocation. Clinically relevant changes in fatigue severity were observed in 66% (41/62) of patients in AAF, 49% (27/55) of patients in eMBCT, and 12% (6/50) of patients in psycho-education. Dropout was 18% (11/62) in AAF, mainly due to technical problems and poor usability of the accelerometer, and 38% (21/55) in eMBCT, mainly due to the perceived high intensity of the program.ConclusionsBoth the AAF and eMBCT interventions are effective for managing fatigue severity compared to receiving psycho-educational emails.Trial RegistrationTrialregister.nl NTR3483; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3483 (Archived by WebCite at http://www.webcitation.org/6NWZqon3o)

Consolidation and prediction of long-term treatment effect of group and online mindfulness-based cognitive therapy for distressed cancer patients

“…A small waitlist randomized-controlled trial (RCT) about an online group mindfulness-based intervention (MBI) for cancer patients revealed positive effects on stress symptoms and mood disturbances [14]. Moreover, an active-controlled study showed eMBCT could reduce cancer-related fatigue [15]. Our research group conducted a large RCT (the BeMind project) comparing group MBCT with individual eMBCT, showing that both types of treatments are superior to usual care [16].…”

Bridging the distance: Continuing psycho‐oncological care via video‐consults during the COVID‐19 pandemic

“…Clients mainly suffer from severe cancer-related fatigue, anxiety, trauma, stressrelated and depressive disorders, relationship problems and/or prolonged grief disorder. Since 2009 the institute offers specific internetbased interventions for cancer patients, such as Mindfulness-Based Cognitive Therapy (MBCT) for cancer-related fatigue 1,2 and Anxiety and Depression, 3,4 self-help and blended Cognitive Behavioural Therapy (CBT) for fear of cancer recurrence 5,6 within a secure environment.…”

Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

“…peak oxygen uptake, heart rate, rating of perceived exertion (RPE) and blood lactate) is reported for the purpose of characterizing the test and describing the sub-study participants. Borg's RPE scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) [29] was administered according to published instructions [30]. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…CRF that continues for months or years has been called chronic CRF [4] or post-cancer fatigue [6]. Although there is no strict consensus on when CRF can be described as chronic, we and other research groups [6,7] define chronic CRF/post-cancer fatigue as clinically-relevant CRF that continues for ≥3 months after the completion of cancer treatment.…”