Effectiveness of nurse-led group CBT for hot flushes and night sweats in women with breast cancer: results of the MENOS4 randomised controlled trial
Effectiveness of nurse-led group CBT for hot flushes and night sweats in women with breast cancer: results of the MENOS4 randomised controlled trial
OBJECTIVE: Troublesome hot flushes and night sweats (HFNS) are experienced by many women after treatment for breast cancer, impacting significantly on sleep and quality of life. Cognitive behavioural therapy (CBT) is known to be effective for the alleviation of HFNS. However, it is not known if it can effectively be delivered by specialist nurses. We investigated whether group CBT, delivered by breast care nurses (BCNs), can reduce the impact of HFNS.
METHODS: We recruited women with primary breast cancer following primary treatment with seven or more HFNS/week (including 4/10 or above on the HFNS problem rating scale), from six UK hospitals to an open, randomised, phase 3 effectiveness trial. Participants were randomised to Group CBT or usual care (UC). The primary endpoint was HFNS problem rating at 26 weeks after randomisation. Secondary outcomes included sleep, depression, anxiety and quality of life.
RESULTS: Between 2017 and 2018, 130 participants were recruited (CBT:63, control:67). We found a 46% (6.9-3.7) reduction in the mean HFNS problem rating score from randomisation to 26 weeks in the CBT arm and a 15% (6.5-5.5) reduction in the UC arm (adjusted mean difference -1.96, CI -3.68 to -0.23, P = .039). Secondary outcomes, including frequency of HFNS, sleep, anxiety and depression all improved significantly.
CONCLUSION: Our results suggest that specialist nurses can be trained to deliver CBT effectively to alleviate troublesome menopausal hot flushes in women following breast cancer in the NHS setting.
CBT, breast cancer, cancer, hot flushes, night sweats, oncology, specialist nurse
1514-1523
Fenlon, Deborah
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Maishman, Tom
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Day, Laura
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Nuttall, Jacqueline
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May, Carl
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Ellis, Mary
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Raftery, James
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Turner, Lesley
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Fields, Jo
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Griffiths, Gareth
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Hunter, Myra S.
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1 October 2020
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Maishman, Tom
cf4259a4-0eef-4975-9c9d-a2c3d594f989
Day, Laura
8e3a589e-6fd6-4d10-82df-5842237b8874
Nuttall, Jacqueline
154aec0a-05f2-4379-918e-9c36767fdc4c
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Ellis, Mary
f9c39516-e078-4d80-807b-9ab91890df41
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Turner, Lesley
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Fields, Jo
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Griffiths, Gareth
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Hunter, Myra S.
fce15222-f73f-478a-87fd-d480cac6fd2a
Fenlon, Deborah, Maishman, Tom, Day, Laura, Nuttall, Jacqueline, May, Carl, Ellis, Mary, Raftery, James, Turner, Lesley, Fields, Jo, Griffiths, Gareth and Hunter, Myra S.
(2020)
Effectiveness of nurse-led group CBT for hot flushes and night sweats in women with breast cancer: results of the MENOS4 randomised controlled trial.
Psycho-Oncology, 29 (10), .
(doi:10.1002/pon.5432).
Abstract
OBJECTIVE: Troublesome hot flushes and night sweats (HFNS) are experienced by many women after treatment for breast cancer, impacting significantly on sleep and quality of life. Cognitive behavioural therapy (CBT) is known to be effective for the alleviation of HFNS. However, it is not known if it can effectively be delivered by specialist nurses. We investigated whether group CBT, delivered by breast care nurses (BCNs), can reduce the impact of HFNS.
METHODS: We recruited women with primary breast cancer following primary treatment with seven or more HFNS/week (including 4/10 or above on the HFNS problem rating scale), from six UK hospitals to an open, randomised, phase 3 effectiveness trial. Participants were randomised to Group CBT or usual care (UC). The primary endpoint was HFNS problem rating at 26 weeks after randomisation. Secondary outcomes included sleep, depression, anxiety and quality of life.
RESULTS: Between 2017 and 2018, 130 participants were recruited (CBT:63, control:67). We found a 46% (6.9-3.7) reduction in the mean HFNS problem rating score from randomisation to 26 weeks in the CBT arm and a 15% (6.5-5.5) reduction in the UC arm (adjusted mean difference -1.96, CI -3.68 to -0.23, P = .039). Secondary outcomes, including frequency of HFNS, sleep, anxiety and depression all improved significantly.
CONCLUSION: Our results suggest that specialist nurses can be trained to deliver CBT effectively to alleviate troublesome menopausal hot flushes in women following breast cancer in the NHS setting.
Text
pon.5432
- Version of Record
More information
Accepted/In Press date: 14 May 2020
e-pub ahead of print date: 27 May 2020
Published date: 1 October 2020
Additional Information:
Funding Information:
Breast Cancer Now commissioned MENOS4(2015CR_004). The commissioning board commented on study design, but no further part in management or analysis. Recruitment was supported by the research nurses and staff within the NIHR Clinical Research Network Cancer in England and Welsh equivalent. We thank Melanie Smith for conducting the fidelity assessment. We thank J. Haviland, L. Yao and P. Khambaita for advising on the original proposal and T. Rose, A. Galanopolou, J. Abab and E. Kirkpatrick for their contribution. Finally, we thank the principal investigators and their colleagues for recruitment and treatment of patients.
Funding Information:
M.S.H. developed the CBT programme and co‐authored the CBT manual, but has no other financial support from pharmaceutical or private practice. D.F.: honorarium from Roche. All others have no conflicts of interest.
Publisher Copyright:
© 2020 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
Keywords:
CBT, breast cancer, cancer, hot flushes, night sweats, oncology, specialist nurse
Identifiers
Local EPrints ID: 442998
URI: http://eprints.soton.ac.uk/id/eprint/442998
ISSN: 1057-9249
PURE UUID: 45303133-7c03-42b9-b5e3-42acf00e1f31
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Date deposited: 05 Aug 2020 16:31
Last modified: 17 Mar 2024 03:36
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Contributors
Author:
Deborah Fenlon
Author:
Tom Maishman
Author:
Laura Day
Author:
Jacqueline Nuttall
Author:
Carl May
Author:
Mary Ellis
Author:
Lesley Turner
Author:
Jo Fields
Author:
Myra S. Hunter
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