1 september 2022: Als aanvulling op onderstaande informatie raadpleeg deze reviewstudie uit januari 2022, abstract onderaan artikel: 

A Systematic Review of Practiced-Based Research of Complementary and Integrative Health Therapies as Provided for Pain Management in Clinical Settings: Recommendations for the Future and a Call to Action


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.

Man met Chinese massage

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.

Table 2.

Distribution of integrative medicine (IM) sessions by treatment type and cancer site*

Cancer site
Any siteBreastColorectalLung, bronchus, and tracheaLymph and hematopoieticProstateOther
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

  1. Jeffery A. Dusek

+ Author Affiliations

  1. Affiliations of authors: Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN (JRJ, KHG, JAD); Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN (DJC); Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, MN (MDF).
  1. 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.

Findings from this systematic review of practice-based, real-word research indicate that CIH therapies exert positive effects on various pain outcomes.

 2022 Jan; 23(1): 189–210.
Published online 2021 May 2. doi: 10.1093/pm/pnab151
PMCID: PMC8932298
PMID: 34009391

A Systematic Review of Practiced-Based Research of Complementary and Integrative Health Therapies as Provided for Pain Management in Clinical Settings: Recommendations for the Future and a Call to Action

Natalie L Dyer, PhD,1 Jessica Surdam, MPH,1 and Jeffery A Dusek, PhDcorresponding author1,2
Author information Copyright and License information Disclaimer

Abstract

Objective

The goal of this systematic review was to evaluate practice-based, real-world research of individualized complementary and integrative health (CIH) therapies for pain as provided in CIH outpatient clinics.

Methods

A systematic review was conducted on articles in PubMed, Ovid, Cochrane, Web of Science, Scopus, and Embase published through December 2020. The study was listed in the PROSPERO database (CRD42020159193). Major categories of variables extracted included study details and demographics, interventions, and outcomes.

Results

The literature search yielded 3,316 records, with 264 assessed for full-text review. Of those, 23 studies (including ∼8,464 patients) were specific to pain conditions as a main outcome. Studies included chiropractic, acupuncture, multimodal individualized intervention/programs, physiotherapy, and anthroposophic medicine therapy. Retention rates ranged from 53% to 91%, with studies offering monetary incentives showing the highest retention. The 0–10 numerical rating scale was the most common pain questionnaire (n = 10; 43% of studies), with an average percent improvement across all studies and time points of 32% (range: 18–60%).

Conclusions

Findings from this systematic review of practice-based, real-word research indicate that CIH therapies exert positive effects on various pain outcomes. Although all studies reported beneficial impacts on one or more pain outcomes, the heterogeneous nature of the studies limits our overall understanding of CIH as provided in clinical settings. Accordingly, we present numerous recommendations to improve publication reporting and guide future research. Our call to action is that future practice-based CIH research is needed, but it should be more expansive and conducted in association with a CIH scientific society with academic and health care members.

Funding sources: Funding was received from the Char and Chuck Fowler Family Foundation and Chris and Sara Connor. This research was partially supported via a U01 cooperative agreement (AT010598) (NCT NCT04880733) to JAD from the National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH). The views espoused in this article are solely attributable to the authors and not to the NCCIH or NIH.

Disclosure and conflicts of interest: Dr. Dusek is the Principal Investigator of BraveNet’s PRIMIER study. Dr. Dusek is also the Chair of the Practice-based Research Scientific Interest Group of the Academic Consortium for Integrative Medicine and Health (the Consortium), and from April 2020 until May 2021 he served as the Research Working Group Chair of the Consortium.

Study registration: PROSPERO database (CRD42020159193).

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Articles from Pain Medicine: The Official Journal of the American Academy of Pain Medicine are provided here courtesy of Oxford University Press

ziekenhuis, kankerpatienten, psychosociale ondersteuning, acupunctuur, aanvullende behandelingen, complementair, massage


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