Tailoring Mind-Body Therapies to Individual Needs: Patients’ Program Preference and Psychological Traits as Moderators of the Effects of Mindfulness-Based Cancer Recovery and Supportive-Expressive Therapy in Distressed Breast Cancer Survivors

Carlson, Linda E.; Tamagawa, Rie; Stephen, Joanne; Doll, Richard; Faris, Peter; Dirkse, Dale; Speca, Michael

doi:10.1093/jncimonographs/lgu034

Cited by 62 publications

(64 citation statements)

References 20 publications

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“…This could, on the other hand, also suggest a possible bias, namely, that patients willing to participate in RCTs are also those who are likely to benefit, even when baseline symptoms are minimal, especially when self‐referral sampling strategies are used . In terms of clinical practice, this could indicate that patients with a preference for MBIs are also those who should be referred to MBIs, which is in accordance with research suggesting that patients benefit more when they receive their preferred treatment …”

Section: Discussionsupporting

confidence: 70%

Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials

et al. 2019

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Objective Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors. Methods Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias. Results Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges's g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention. Conclusions MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

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Section: Discussionsupporting

confidence: 70%

Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials

et al. 2019

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“…Thus, its positive results in improving cancer-related fatigue and quality of life measures cannot directly be extrapolated to other nongynecological cancers. Two other trials examining the effects of multimodal complementary treatments similar to ours, but conducted in breast cancer patients or breast cancer survivors only, also showed a positive effect of such programs on cancer-associated quality of life [34,35] . Hence, while the data of the present trial are consistent with previous studies on multimodal complementary medicine programs, they also illustrate that a broader and more diverse range of patients and cancer entities can benefit from the positive effects of such a treatment program.…”

Section: Discussionsupporting

confidence: 69%

Evaluation of the Effectiveness of a Multimodal Complementary Medicine Program for Improving the Quality of Life of Cancer Patients during Adjuvant Radiotherapy and/or Chemotherapy or Outpatient Aftercare

Domnick

Wiebelitz³

et al. 2017

Oncology

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Objectives: Evidence for complementary therapies as important strategies to relieve cancer treatment-associated symptoms is increasing. Mostly, these complementary therapies start at the end of adjuvant treatments, resulting in a long delay until the well-being of patients is addressed. Further, long distances between the rehabilitation center and the patients' residence hinder patients' compliance. Methods: The multimodal outpatient LOTUS Care Cure Project (LCCP) was tested in a randomized controlled trial including patients of various cancer entities and stages while on adjuvant chemotherapy and/or radiotherapy or outpatient aftercare. The intervention group received the LCCP additionally to the conventional treatment (LCCP group, n = 50). The control group (CG) was split into 2 groups, with (CG1, n = 33) and without (CG2, n = 17) weekly talks. The primary endpoint was quality of life (QoL) after 3 months. Results: In the LCCP group, QoL significantly improved after 3 months compared to CG2 (p = 0.022) but not compared to CG1. Other parameters showing a significant improvement were cognitive (p < 0.05, vs. CG1 and CG2) and social function (p < 0.05, vs. CG2). Conclusions: This pilot study describes a multimodal outpatient complementary therapy program conducted in parallel with conventional therapies and its potential to significantly improve QoL and reduce treatment-associated side effects. To substantiate these data, multicenter trials are needed.

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“…In that large randomized clinical trial we demonstrated that while both active interventions were better than usual care, MBCR was superior to SET over a wide range of outcomes 7,8 , and benefits persisted over a full year of follow-up 9 . We also found that treatment preference at baseline had an effect on outcomes, in that those women who were assigned to their chosen intervention (MBCR, SET or the control condition) improved more over time on quality of life (QL) and stress symptoms than those who did not receive their preferred treatment 8 . Similarly, a systematic review on the influence of preference on clinical outcomes in acupuncture trials reported that preference was associated with reduced program attrition, with most studies demonstrating an effect of preference on outcome, though few were clinically significant 10 .…”

Section: Introductionmentioning

confidence: 83%

Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors

Carlson

Zelinski

Speca

et al. 2017

Contemporary Clinical Trials

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Purpose A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics. Methods and Significance The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N = 600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of Mood States (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/heart rate variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.

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Tailoring Mind-Body Therapies to Individual Needs: Patients’ Program Preference and Psychological Traits as Moderators of the Effects of Mindfulness-Based Cancer Recovery and Supportive-Expressive Therapy in Distressed Breast Cancer Survivors

Cited by 62 publications

References 20 publications

Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials

Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials

Evaluation of the Effectiveness of a Multimodal Complementary Medicine Program for Improving the Quality of Life of Cancer Patients during Adjuvant Radiotherapy and/or Chemotherapy or Outpatient Aftercare

Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors

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