Artikel
Beneficial effects of integrative non-pharmacological interventions for breast cancer patients on quality of life
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Autoren
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Shiao Li Oei
- Forschungsinstitut Havelhöhe, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
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Anja Thronicke
- Forschungsinstitut Havelhöhe, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
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Harald Matthes
- Forschungsinstitut Havelhöhe, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland; Institute of Social Medicine, Epidemiology and Health Economics and Medical Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
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Friedemann Schad
- Forschungsinstitut Havelhöhe, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland; Interdisciplinary Oncology and Palliative Care, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
| Veröffentlicht: | 25. September 2020 |
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Gliederung
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Background: Cancer has a huge impact on the health-related quality of life (HRQL). Systemic oncology treatments, such as chemotherapy have various side effects and may lead to cognitive, physical, and functional impairments. Therefore, to improve HRQL, an increasing number of breast cancer patients wish to make use of a patient-centered approach of integrative medicine methods including add-on non-pharmacological interventions (NPIs). One well established patient-reported outcome measurement for HRQL is the European Organization for Research and Treatment of Cancer EORTC QLQ-C30.
Questions and objectives: The effects of individual components of a patient-centered integrative medicine program on self-reported HRQL of breast cancer patients should be analyzed. In the present study the EORTC QLQ-C30 was used to evaluate medium-term HRQL effects of NPIs applied alongside with oncological standard therapy in breast cancer patients.
Methods: Using data from the Network Oncology clinical registry a longitudinal prospective real-world study was conducted. Primary breast cancer patients treated with standard oncological therapy and add-on NPIs, comprising art therapy, rhythmic massage, nursing interventions, movement therapy, and educational components, were included. At first diagnosis and 12 months later, the EORTC QLQ-C30 was administered to these patients and evaluated.
Results: 231 patients (median age 59 years, IQR: 51-69) receiving standard oncological treatment and various NPIs were assessed. Multivariable linear regression analyses, adjusted for demographic variables, cancer stage, hormonal status, and body mass index revealed that in particular the NPIs elaborate consultations and life review (ECLR), nursing compresses, and music therapy were significantly associated with improvements of 8 to 13 point changes (p < 0.05) for functional scales, global health, and symptoms fatigue, dyspnea, insomnia, and financial difficulties.
Discussion: Although breast cancer patients often make use of integrative medicine methods, only little is known on the potential benefits of the included treatment components. Here, in our real-world analysis we quantified the distinct effects of treatment components on different parameters of self-reported HRQL. With the evaluation of real-world data it is shown here that breast cancer patients benefit from the concept of integrative medicine including NPIs. From our analysis we can conclude, that implemented integrative inpatient treatments have sustainable beneficial effects on self-reported HRQL, detectable even 12 months after hospital stay.
Implications for practice: This prospective longitudinal breast cancer real-world study analyzed the effects of a hospital-based integrative medicine program with add-on NPIs on HRQL. To improve the quality of care for breast cancer patients, a continuation and expansion of this multimodal patient-centered treatment concept should be developed in the future.
