Systematic review of the effectiveness of self-initiated interventions to decrease pain and sensory disturbances associated with peripheral neuropathy

Abstract

Purpose A small number of studies report that patients with peripheral neuropathy (PN) who engage in activities that promote a sense of personal well-being and provide physical, emotional, or spiritual comfort have a better quality of life and higher levels of adjustment to the changes generated by their illness and accompanying symptoms. This systematic review sought to evaluate the effectiveness of self-management activities that patients with PN initiate themselves to relieve PN symptoms and improve quality of life. Methods Search terms were limited to include self-management activities initiated by patients (i.e., activities with no or minimal involvement from clinicians) that aim to provide relief of PN symptoms. Outcomes included in searches were pain, numbness, and tingling, associated with PN and quality of life. Results The database searches identified 2979 records, of which 1620 were duplicates. A total of 1322 papers were excluded on the basis of screening the abstract. An additional 21 full text articles were excluded because they did not meet the eligibility criteria. A total of 16 papers were included in the review. Conclusion This review identified that a number of self-management strategies that were initiated by patients, including heat, exercise, meditation, and transcutaneous electrical nerve stimulation (TENS) therapy, may reduce self-reported PN symptoms. As the available studies were of low quality, these strategies warrant further investigation with more homogeneous samples, using more rigorously designed trials and larger samples. Implications for Cancer Survivors Patients experiencing PN may find a range of self-initiated strategies beneficial in reducing PN symptoms and improving quality of life. However, because of the low quality of the available studies, clinicians need to monitor patients' responses to determine the effectiveness of these interventions as adjuncts to clinician-initiated interventions.

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

“…To date, no review of CIPN-specific behavioural interventions has been conducted. A systematic review, focused on studies involving patient self-management to reduce symptoms of peripheral neuropathy (PN) caused by a range of conditions such as diabetes, HIV and other autoimmune disorders, reported that self-initiated interventions may reduce self-reported PN symptoms [26]. But results may not be wholly applicable when managing neuropathy in the context of cancer chemotherapy because CIPN is an unintended consequence of chemotherapy treatment that also brings associated psychosocial complexities [4].…”

A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs

“…However, a previous review on self-initiated interventions among patients with cancer with peripheral neuropathy showed that strategies were beneficial in reducing symptoms and concerns. 107 …”

Non-Pharmacological Self-Management Strategies for Chemotherapy-Induced Peripheral Neuropathy in People with Advanced Cancer: A Systematic Review and Meta-Analysis

“…Advanced cancer was defined as any hematological cancer or any solid tumor with locally or systemically advanced disease (The Union for International Cancer Control Tumor, Nodes, and Metastases Classification of Malignant Tumors (UICC TNM) Stage of III-IV or equivalent) [26]. Self-management strategies were defined as interventions that were administered by the person with cancer or their caregivers, including those initiated with support from a health professional as well as initiated independently [20,21]. Eligibility criteria is presented in Table 1.…”

“…Additional suggested areas of research include those which have shown benefit in the general cancer population but are yet to be tested in advanced cancer. This includes low-cost and easily accessible interventions of massage, heat therapy, and meditation [20,59]. Future studies should also explore how non-pharmacological self-management interventions may best be implemented in conventional cancer care.…”

“…Non-pharmacological interventions for CIPN that can be self-administered are of particular interest, as symptom self-management strategies are often effective in achieving improved wellbeing, quality of life, self-efficacy, a broader reach of health services, and cost savings in people with cancer [17][18][19]. Self-management strategies can be initiated independently from an internal decision (e.g., massage) or with support from a health professional (e.g., an exercise program) but include only those interventions that the patient is responsible for administering (i.e., not acupuncture) [20,21]. To date, no systematic reviews or clinical guidelines have assessed non-pharmacological self-management strategies specifically for advanced cancer patients, where chemotherapy use and CIPN is common, co-morbidities are high, and daily functioning and overall quality of life are often more valued than enhanced treatment outcomes or survival [22].…”