Research Article
A Pragmatic Evaluation of the National Cancer Institute Physician Data Query (PDQ)®-Based Brief Counseling on Cancer-Related Fatigue among Patients Undergoing Radiation Therapy
Joshua Bauml1, Sharon X Xie2, Courtney Penn BA3, Krupali Desai3, Kimberly W Dong3, Deborah Watkins Bruner1,4,5, Neha Vapiwala1,4 and Jun James Mao1,2,3*
1Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street / 2 Gates, Philadelphia, Pennsylvania 19104, USA
2Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
3Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, USA
4Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street / 2 Gates, Philadelphia, Pennsylvania 19104, USA
5Woodruff School of Nursing, University of Emory, Georgia 30322, USA
- *Corresponding Author:
- Dr. Jun J Mao, MD, MSCE
Department of Family Medicine and Community Health
University of Pennsylvania, 3400 Spruce Street / 2 Gates
Philadelphia, Pennsylvania 19104, USA
Tel: 215-615-4330
Fax: 215-662-3591
E-mail: jun.mao@uphs.upenn.edu
Received date: July 13, 2012; Accepted date: August 06, 2012; Published date: August 08, 2012
Citation: Bauml J, Xie SX, Penn BAC, Desai K, Dong KW, et al. (2012) A Pragmatic Evaluation of the National Cancer Institute Physician Data Query (PDQ)®-Based Brief Counseling on Cancer-Related Fatigue among Patients Undergoing Radiation Therapy. J Palliative Care Med 2:125 doi: 10.4172/2165-7386.1000125
Copyright: © 2012 Bauml J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Purpose: Cancer-Related Fatigue (CRF) negatively affects quality of life among cancer patients. This study seeks to evaluate the outcome and patient receptiveness of a brief counseling program based on National Cancer Institute (NCI) PDQ® information to manage CRF when integrated into Radiation Therapy (RT). Methods: We conducted a prospective cohort study among patients undergoing non-palliative RT. Patients with stage I-III tumors and with Karnofsky score 60 or better were given a ten-minute behavioral counseling session during the first two weeks of RT. The Brief Fatigue Inventory (BFI) was administered at baseline/end of RT. Results: Of 93 patients enrolled, 89% found the counseling useful and practical. By the end of RT, 59% reported increased exercise, 41.6% sought nutrition counseling, 72.7% prioritized daily activities, 74.4% took daytime naps, and 70.5% talked with other cancer patients. Regarding counseling, patients who had received chemotherapy prior to RT had no change in fatigue (-0.2), those who received RT alone had mild increase in fatigue (0.7, p=0.02), and those who received concurrent chemotherapy experienced a substantial increase in fatigue (3.0 to 5.2, p=0.05). Higher baseline fatigue and receipt of chemotherapy were predictive of worsened fatigue in a multivariate model (both p<0.01). Conclusion: Our data suggests that brief behavioral counseling based on NCI guidelines is well accepted by patients showing an uptake in many activities to cope with CRF. Those who receive concurrent chemotherapy and with higher baseline fatigue are at risk for worsening fatigue despite of guideline-based therapy
