10 november 2014: Bron: Journal of the National Cancer Institute Monographs.
"De omvang van deze vermindering is klinisch belangrijk want theoretisch zouden deze behandelingen even effectief kunnen zijn dan de standaard aanpak met chemische pijnstillers enz. wat de volgende stap in ons onderzoek zal zijn." aldus Jeffery Dusek, PhD, senior author and Research Director for the Penny George Institute.
Studieresultaten:
De onderzoekers analyseerden de electronische medische dossiers van ruim 10.000 kankerpatiënten. in de periode van 1 juli 2009 tot 31 december 2012. 1,833 patiënten kregen complementaire behandelingen om hun pijn en angst te verminderen.
Patiënten werd gevraagd om hun pijn en angsten te beschrijven voor en na de aanvullende behandeling die gemiddeld 30 minuten duurde.
Patiënten die werden behandeld voor tumoren in de longen, luchtwegen en keel toonden de grootste vermindering in pijn met 51%. Patiënten met prostaatkanker ervaarden de grootste vermindering in angst met 64%.
Hier een tabel uit het studierapport die aangeeft welke vormen van complementaire behandelingen werden toegepast en bij welke vorm van kanker. Onderaan staat de link naar het volledige studierapport waarin nog meer tabellen zijn opgenomen.
Distribution of integrative medicine (IM) sessions by treatment type and cancer site*
| Cancer site | |||||||
|---|---|---|---|---|---|---|---|
| Any site | Breast | Colorectal | Lung, bronchus, and trachea | Lymph and hematopoietic | Prostate | Other | |
| Number of oncology admissions with IM therapy | 1833 | 279 | 128 | 155 | 274 | 57 | 978 |
| Number of total IM sessions (%) | 4517 (100.0) | 554 (100.0) | 404 (100.0) | 368 (100.0) | 849 (100.0) | 163 (100.0) | 2326 (100.0) |
| BW (%) | 2474 (54.8) | 244 (44.0) | 207 (51.2) | 203 (55.2) | 450 (53.0) | 98 (60.1) | 1352 (58.1) |
| Craniosacral | 2 (<0.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.1) | 0 (0.0) | 1 (<0.1) |
| Medical massage | 1782 (39.5) | 174 (31.4) | 150 (37.1) | 178 (48.4) | 282 (33.2) | 87 (53.4) | 964 (41.4) |
| Reflexology | 666 (14.7) | 65 (11.7) | 56 (13.9) | 25 (6.8) | 163 (19.2) | 11 (6.7) | 373 (16.0) |
| Multiple BW treatments | 24 (0.5) | 5 (0.9) | 1 (0.2) | 0 (0.0) | 4 (0.5) | 0 (0.0) | 14 (0.6) |
| MBE (%) | 587 (13.0) | 85 (15.3) | 56 (13.9) | 44 (12.0) | 174 (20.5) | 7 (4.3) | 242 (10.4) |
| Mind-body | 255 (5.6) | 31 (5.6) | 24 (5.9) | 23 (6.3) | 65 (7.7) | 5 (3.1) | 111 (4.8) |
| Energy | 267 (5.9) | 47 (8.5) | 21 (5.2) | 16 (4.3) | 89 (10.5) | 2 (1.2) | 103 (4.4) |
| Multiple MBE treatments | 65 (1.4) | 7 (1.3) | 11 (2.7) | 5 (1.4) | 20 (2.4) | 0 (0.0) | 28 (1.2) |
| TCM (%) | 437 (9.7) | 53 (9.6) | 44 (10.9) | 27 (7.3) | 53 (6.2) | 35 (21.5) | 232 (10.0) |
| Acupressure | 104 (2.3) | 13 (2.3) | 10 (2.5) | 9 (2.4) | 10 (1.2) | 9 (5.5) | 56 (2.4) |
| Acupuncture | 217 (4.8) | 25 (4.5) | 27 (6.7) | 17 (4.6) | 26 (3.1) | 14 (8.6) | 110 (4.7) |
| Korean hand therapy | 54 (1.2) | 8 (1.4) | 5 (1.2) | 1 (0.3) | 10 (1.2) | 6 (3.7) | 24 (1.0) |
| Multiple TCM treatments | 62 (1.4) | 7 (1.3) | 2 (0.5) | 0 (0.0) | 7 (0.8) | 6 (3.7) | 42 (1.8) |
| Combination therapy (%) | 1019 (22.6) | 172 (31.0) | 97 (24.0) | 94 (25.5) | 172 (20.3) | 23 (14.1) | 500 (21.5) |
| BW-MBE | 671 (14.9) | 111 (20.0) | 66 (16.3) | 73 (19.8) | 120 (14.1) | 12 (7.4) | 318 (13.7) |
| BW-TCM | 118 (2.6) | 16 (2.9) | 11 (2.7) | 8 (2.2) | 21 (2.5) | 4 (2.5) | 62 (2.7) |
| MBE-TCM | 168 (3.7) | 26 (4.7) | 16 (4.0) | 6 (1.6) | 25 (2.9) | 7 (4.3) | 94 (4.0) |
| BW-MBE-TCM | 62 (1.4) | 19 (3.4) | 4 (1.0) | 7 (1.9) | 6 (0.7) | 0 (0.0) | 26 (1.1) |
-
↵* IM sessions for patients with more than one cancer during a hospital admission count under the “Any site” column as well as under the appropriate cancer site columns. As such, the sum of individual cancer site columns does not equal the sum of the “Any site” column. BW = bodywork; MBE = mind-body and energy therapy; TCM = traditional Chinese medicine.
Het volledige studierapport: Effects of Integrative Medicine on Pain and Anxiety Among Oncology Inpatients is tegen betaling in te zien.
Hier het abstract van de studie:
IM services (integrative medicine) to oncology inpatients resulted in substantial decreases in pain and anxiety. Observational studies using electronic medical records provide unique information about real-world utilization of IM. Future studies are warranted and should explore potential synergy of opioid analgesics and IM therapy for pain control
Effects of Integrative Medicine on Pain and Anxiety Among Oncology Inpatients
+ Author Affiliations
- Correspondence to: Jill R. Johnson, PhD, MPH, Penny George Institute for Health and Healing, 800 East 28th Street, MR 33540, Minneapolis, MN 55407-3799 (e-mail: Jill.Johnson3@allina.com)
Abstract
Background Few studies have investigated the effectiveness of integrative medicine (IM) therapies on pain and anxiety among oncology inpatients.
Methods Retrospective data obtained from electronic medical records identified patients with an oncology International Classification of Diseases-9 code who were admitted to a large Midwestern hospital between July 1, 2009 and December 31, 2012. Outcomes were change in patient-reported pain and anxiety, rated before and after individual IM treatment sessions, using a numeric scale (0–10).
Results Of 10948 hospital admissions over the study period, 1833 (17%) included IM therapy. Older patients had reduced odds of receiving any IM therapy (odds ratio : 0.97, 95% confidence interval [95% CI] = 0.96 to 0.98) and females had 63% (OR: 1.63, 95% CI = 1.38 to 1.92) higher odds of receiving any IM therapy compared with males. Moderate (OR: 1.97, 95% CI = 1.61 to 2.41), major (OR: 3.54, 95% CI = 2.88 to 4.35), and extreme (OR: 5.96, 95% CI = 4.71 to 7.56) illness severity were significantly associated with higher odds of receiving IM therapy compared with admissions of minor illness severity. After receiving IM therapy, patients averaged a 46.9% (95% CI = 45.1% to 48.6%, P <.001) reduction in pain and a 56.1% (95% CI = 54.3% to 58.0%, P <.001) reduction in anxiety. Bodywork and traditional Chinese Medicine therapies were most effective for reducing pain, while no significant differences among therapies for reducing anxiety were observed.
Conclusions IM services to oncology inpatients resulted in substantial decreases in pain and anxiety. Observational studies using electronic medical records provide unique information about real-world utilization of IM. Future studies are warranted and should explore potential synergy of opioid analgesics and IM therapy for pain control.
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