|
1
|
Abrahams HJG, Knoop H, Schreurs M, Aaronson NK, Jacobsen PB, Newton RU, Courneya KS, Aitken JF, Arving C, Brandberg Y, Chambers SK, Gielissen MFM, Glimelius B, Goedendorp MM, Graves KD, Heiney SP, Horne R, Hunter MS, Johansson B, Northouse LL, Oldenburg HSA, Prins JB, Savard J, van Beurden M, van den Berg SW, Verdonck-de Leeuw IM, Buffart LM. Moderators of the effect of psychosocial interventions on fatigue in women with breast cancer and men with prostate cancer: Individual patient data meta-analyses. Psychooncology 2020; 29:1772-1785. [PMID: 33448521 DOI: 10.1002/pon.5522] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/05/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychosocial interventions can reduce cancer-related fatigue effectively. However, it is still unclear if intervention effects differ across subgroups of patients. These meta-analyses aimed at evaluating moderator effects of (a) sociodemographic characteristics, (b) clinical characteristics, (c) baseline levels of fatigue and other symptoms, and (d) intervention-related characteristics on the effect of psychosocial interventions on cancer-related fatigue in patients with non-metastatic breast and prostate cancer. METHODS Data were retrieved from the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium. Potential moderators were studied with meta-analyses of pooled individual patient data from 14 randomized controlled trials through linear mixed-effects models with interaction tests. The analyses were conducted separately in patients with breast (n = 1091) and prostate cancer (n = 1008). RESULTS Statistically significant, small overall effects of psychosocial interventions on fatigue were found (breast cancer: β = -0.19 [95% confidence interval (95%CI) = -0.30; -0.08]; prostate cancer: β = -0.11 [95%CI = -0.21; -0.00]). In both patient groups, intervention effects did not differ significantly by sociodemographic or clinical characteristics, nor by baseline levels of fatigue or pain. For intervention-related moderators (only tested among women with breast cancer), statistically significant larger effects were found for cognitive behavioral therapy as intervention strategy (β = -0.27 [95%CI = -0.40; -0.15]), fatigue-specific interventions (β = -0.48 [95%CI = -0.79; -0.18]), and interventions that only targeted patients with clinically relevant fatigue (β = -0.85 [95%CI = -1.40; -0.30]). CONCLUSIONS Our findings did not provide evidence that any selected demographic or clinical characteristic, or baseline levels of fatigue or pain, moderated effects of psychosocial interventions on fatigue. A specific focus on decreasing fatigue seems beneficial for patients with breast cancer with clinically relevant fatigue.
Collapse
Affiliation(s)
- Harriët J G Abrahams
- Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maartje Schreurs
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paul B Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Joanne F Aitken
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Cancer Council Queensland, Brisbane, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Cecilia Arving
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, Western Australia, Australia
| | | | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Martine M Goedendorp
- Department of Health Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kristi D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Sue P Heiney
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Rob Horne
- UCL School of Pharmacy, University College London, London, UK
| | - Myra S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Birgitta Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Hester S A Oldenburg
- Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van, Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, Radboud, Institute for Health Sciences, Nijmegen, The Netherlands
| | - Josée Savard
- School of Psychology, Université Laval and Laval University Cancer Research Center, Quebec City, Québec, Canada
| | - Marc van Beurden
- Department of Gynecology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|