Tofthagen, C., Boses, S., Healy, G., & Jooma, N. (2015). Evaluation of group acupuncture for cancer-related symptoms: A retrospective analysis. Journal of Palliative Medicine, 18, 878–880.
DOI Link
Study Purpose
To evaluate the effects of group acupuncture on specific cancer-related symptoms in persons with cancer receiving outpatient treatment
Intervention Characteristics/Basic Study Process
Retrospective participants completed an assessment prior to the first study and following weekly treatments; received group acupuncture at a rate of up to eight patients an hour provided in a staggered fashion by one practitioner. Meridian diagnosis established the acupoint prescription based on patient symptom complaint. Instead of standardized treatments, many factors were considered to tailor individual acupuncture treatments for the patients symptoms.
Sample Characteristics
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N = 43
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AGE RANGE = 25–84 years
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MEAN AGE = 66.1 years
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MALES: 27.2%, FEMALES: 73.8%
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KEY DISEASE CHARACTERISTICS: Breast cancer was the most common diagnosis.
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OTHER KEY SAMPLE CHARACTERISTICS: Caucasian (88.1%), non-Hispanic (76.2%)
Setting
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SITE: Single site
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SETTING TYPE: Outpatient
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LOCATION: West Central Florida
Phase of Care and Clinical Applications
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PHASE OF CARE: Undescribed
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APPLICATIONS: Elder care, palliative care
Study Design
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Retrospective descriptive analysis
Measurement Instruments/Methods
Patients completed a pre-study and pre-treatment assessment for seven basic cancer-related symptoms (pain/numbness, dry mouth, headache, fatigue, sleep trouble, nausea, digestion) on a numeric rating scale (0–10).
Results
Patients who completed four group acupuncture treatments reported significantly less pain/numbness and problems with digestion. There were no significant changes in any of the other symptoms (sleep, fatigue, dry mouth, headache, or nausea). Comparing baseline symptom data to week 3 revealed no significant improvement for any symptom.
Conclusions
This retrospective analysis pilot study of mostly patients with breast cancer with unknown treatment/medical history were evaluated over four weeks of acupuncture treatment, revealing significantly reduced reports of pain/numbness and digestive complaints after the fourth treatment. It could not be determined if this was clinically meaningful or a durable response.
Limitations
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Small sample (< 100)
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Baseline sample/group differences of import
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Risk of bias (no control group)
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Risk of bias (no blinding)
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Risk of bias (no random assignment)
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Risk of bias (no appropriate attentional control condition)
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Risk of bias (sample characteristics)
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Unintended interventions or applicable interventions not described that would influence results
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Key sample group differences that could influence results
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Measurement validity/reliability questionable
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Findings not generalizable
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Retrospective study; study subjects not ethnically diverse; symptom data presented only for four weeks; no explanation for competencies and treatment standards as performed by acupuncture practitioner(s); same or different practitioner each week unknown; predominantly patients with breast cancer; unknown phases of care; limited data description of patient population tumor types; no data for prior/concurrent treatment or side effects of therapy; potential confounding variables—inclusion/exclusion criteria; pain/numbness measured as one symptom; incomplete symptom evaluation, no standardized measurement tool for PN used; internal and external validity limited due to study design; sample characteristics and unknown sampling technique; not mentioned if assumptions were met for paired t-test
Nursing Implications
This pilot study identified that group acupuncture may be a beneficial treatment for PN. Prospective randomized, controlled trials with validated measures and complete symptom evaluation are needed to investigate meaningful therapeutic benefits, doses, frequency, side effects, and duration of response to group acupuncture in specific populations, tumor types, and neurotoxic regimens.