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Curr Opin Support Palliat Care. 2013 Mar;7(1):60-6. doi: 10.1097/SPC.0b013e32835c7d88.

Update on interventions focused on symptom clusters: what has been tried and what have we learned?

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1
College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska 68198-5330, USA. aberger@unmc.edu

Abstract

PURPOSE OF REVIEW:

Although clinicians and researchers acknowledge symptom clusters, the focus has been on relieving a single symptom. This review summarizes the recent literature on interventions that focus on relief of symptom clusters in patients with cancer.

RECENT FINDINGS:

Twelve intervention studies meeting inclusion criteria were published in 2011-2012. The timeframe was expanded to 2009-2012 and 24 studies met the criteria: 18 in early stage and 6 in advanced-stage cancer patients. Several cognitive behavioral therapy, complementary therapy, and exercise interventions demonstrated positive outcomes in relieving a variety of symptom clusters in several cancer types. Most psychoeducational interventions using traditional formats or those combined with automated clinician alerts demonstrated effectiveness in reducing a variety of clusters. Clusters that included fatigue and anxiety or depression were reduced by exercise in early stage patients and by methylphenidate in advanced-stage patients. Current NIH R01 funded studies verified the trends in the types of interventions being tested.

SUMMARY:

Few interventions have been tested and found to be effective in relieving the specific symptom clusters in early and advanced-stage cancer patients. Future research needs to expand our understanding of the mechanisms that initiate co-occurring symptoms. Mechanism-targeted interventions need to be identified and tested in homogeneous samples with specific symptom clusters. Interventions need to be replicated before guidelines can be established.

PMID:
23364298
DOI:
10.1097/SPC.0b013e32835c7d88
[Indexed for MEDLINE]
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