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

• Published in: Cancer 2004-03, Vol.100 (6), p.1302-1310
• Main Authors: Barsevick, Andrea M., Dudley, William, Beck, Susan, Sweeney, Carole, Whitmer, Kyra, Nail, Lillian
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biological and medical sciences; Energy Metabolism - drug effects; Energy Metabolism - physiology; fatigue; Fatigue - chemically induced; Fatigue - therapy; Female; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasms - complications; Neoplasms - therapy; Nutritional Physiological Phenomena - physiology; quality of life; Radiotherapy - adverse effects; symptom clusters; symptom management; Treatment Outcome; Tumors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.20111

BACKGROUND The 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. METHODS A 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. RESULTS A 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. CONCLUSIONS Individuals 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. In a randomized clinical trial, an energy conservation activity management (ECAM) intervention for fatigue reduction was compared with a control intervention focused on nutrition. The results demonstrated a statistically significant difference over time between the intervention groups favoring the ECAM intervention.