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Simms-Moore R, Dures E, Barua N, Cramp F. Non-pharmacological fatigue interventions for patients with a primary brain tumour: a scoping review protocol. BMJ Open 2023; 13:e078183. [PMID: 38101835 PMCID: PMC10729204 DOI: 10.1136/bmjopen-2023-078183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Fatigue is the most prevalent symptom for patients with a primary brain tumour (PBT), significantly reducing quality of life and limiting daily activities. Currently, there are limited options for managing cancer-related fatigue (CRF) in patients with a PBT, using non-pharmacological methods. The objective of this scoping review is to identify current and emerging evidence in relation to non-pharmacological CRF interventions for patients with a PBT. METHODS AND ANALYSIS Electronic databases OVID and EBSCO platforms: MEDLINE, EMBASE and CINAHL will be searched. In addition, PROSPERO, The Cochrane Library and ISI Web of Science will be searched. Trials registries CENTRAL and the International Clinical Trials Registry platform will also be searched for ongoing research. INCLUSION CRITERIA studies from 2006 onwards, primary research on non-pharmacological interventions in patients with a PBT (>18 years). A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram will be utilised to summarise the screening process and results.Quantitative data will be analysed descriptively, while content analysis will be used for qualitative data.Findings will map the existing and emerging evidence on non-pharmacological interventions for CRF in patients with PBTs. This will provide insights into the extent and nature of the evidence in this evolving field, identifying gaps in knowledge and research priorities, and guide further investigations in this area. ETHICS AND DISSEMINATION Ethical approval is not required for this scoping review. Findings will be disseminated via relevant peer-reviewed journals, PhD thesis, conference presentations, and shared with relevant charities and health professionals.
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Affiliation(s)
- Rachael Simms-Moore
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Emma Dures
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Neil Barua
- Neurosurgery, Southmead Hospital, Bristol, UK
| | - Fiona Cramp
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
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Rooney AG, Hewins W, Walker A, Mackinnon M, Withington L, Robson S, Torrens C, Hopcroft LEM, Clark A, Anderson G, Bulbeck H, Dunlop J, Welsh M, Dyson A, Emerson J, Cochrane C, Hill R, Carruthers J, Day J, Gillespie D, Hewitt C, Molinari E, Wells M, McBain C, Chalmers AJ, Grant R. Lifestyle coaching is feasible in fatigued brain tumor patients: A phase I/feasibility, multi-center, mixed-methods randomized controlled trial. Neurooncol Pract 2023; 10:249-260. [PMID: 37188163 PMCID: PMC10180387 DOI: 10.1093/nop/npac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background There are no effective treatments for brain tumor-related fatigue. We studied the feasibility of two novel lifestyle coaching interventions in fatigued brain tumor patients. Methods This phase I/feasibility multi-center RCT recruited patients with a clinically stable primary brain tumor and significant fatigue (mean Brief Fatigue Inventory [BFI] score ≥ 4/10). Participants were randomized in a 1-1-1 allocation ratio to: Control (usual care); Health Coaching ("HC", an eight-week program targeting lifestyle behaviors); or HC plus Activation Coaching ("HC + AC", further targeting self-efficacy). The primary outcome was feasibility of recruitment and retention. Secondary outcomes were intervention acceptability, which was evaluated via qualitative interview, and safety. Exploratory quantitative outcomes were measured at baseline (T0), post-interventions (T1, 10 weeks), and endpoint (T2, 16 weeks). Results n = 46 fatigued brain tumor patients (T0 BFI mean = 6.8/10) were recruited and 34 were retained to endpoint, establishing feasibility. Engagement with interventions was sustained over time. Qualitative interviews (n = 21) suggested that coaching interventions were broadly acceptable, although mediated by participant outlook and prior lifestyle. Coaching led to significant improvements in fatigue (improvement in BFI versus control at T1: HC=2.2 points [95% CI 0.6, 3.8], HC + AC = 1.8 [0.1, 3.4], Cohen's d [HC] = 1.9; improvement in FACIT-Fatigue: HC = 4.8 points [-3.7, 13.3]; HC + AC = 12 [3.5, 20.5], d [HC and AC] = 0.9). Coaching also improved depressive and mental health outcomes. Modeling suggested a potential limiting effect of higher baseline depressive symptoms. Conclusions Lifestyle coaching interventions are feasible to deliver to fatigued brain tumor patients. They were manageable, acceptable, and safe, with preliminary evidence of benefit on fatigue and mental health outcomes. Larger trials of efficacy are justified.
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Affiliation(s)
- Alasdair G Rooney
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- The Robert Fergusson Unit, Royal Edinburgh Hospital, Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William Hewins
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Amie Walker
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Mairi Mackinnon
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Lisa Withington
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Sara Robson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Claire Torrens
- Nursing, Midwifery, and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Lisa E M Hopcroft
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Antony Clark
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | | | | | - Joanna Dunlop
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Community Rehabilitation and Brain Injury Service, Livingston, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Michelle Welsh
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Aimee Dyson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Julie Emerson
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Robert Hill
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Jade Carruthers
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
| | - Julia Day
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Community Rehabilitation and Brain Injury Service, Livingston, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - David Gillespie
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Emanuela Molinari
- Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Mary Wells
- Scottish Clinical Trials Research Unit (SCTRU), Public Health Scotland, Edinburgh, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Catherine McBain
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Anthony J Chalmers
- Neuro-Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
- Institute of Neurosciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Robin Grant
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Department of Clinical Neurosciences, Edinburgh Centre for Neuro-Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK
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