Adapting an Evidence-Based Intervention to Address Targeted Therapy-Related Fatigue in Chronic Myeloid Leukemia Patients.
Hanneke Poort, Cathy D Meade, Hans Knoop and 3 others
PMID 27832018WHAT IT FOUND
Ten CML patients and four providers described fatigue as crushing and said patients often did not raise it.
They viewed a tailored video CBT program as worthwhile, prioritizing activity, sleep, and coping, and wanted clearer education about TKIs and monitoring.
Key findings
01Patients commonly described fatigue as crushing and said they did not often raise it with providers, while providers reported that fatigue was common in an estimated 70% or more of their CML patients.
02Patients prioritized Activity, Sleep, and Coping with Cancer as highest-priority modules, but most did not see Helpful Thinking as applicable to them.
03Patients were receptive to FaceTime/iPad delivery of weekly 18-week CBT, and no differences were found between younger and older patients in acceptability, despite providers' concerns about older patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 10 patients and 4 providers from a single cancer center were interviewed, so the findings may not represent other CML populations or health care settings. The study was formative. It reports interviews and adaptation decisions, not patient outcomes, so it does not show that the adapted program reduces fatigue. The pilot randomized trial testing the adapted intervention had not been completed or reported in this paper. Patient participants were English-speaking, chronic phase CML, on a TKI for at least 3 months, and had moderate-to-severe fatigue, so results may not apply to patients with earlier or later disease, other language needs, or milder fatigue. Provider statements about fatigue prevalence and dose skipping were impressions from interviews, not measured patient data. The sample of providers was limited to the small number at the institution who primarily cared for CML patients.
Declared interests
The authors declared no conflict of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude that this video-delivered CBT program reduces fatigue in CML patients. This paper reports interviews and adaptation steps only, and the pilot randomized trial testing efficacy was not completed.