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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
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
1057-9249
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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Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Maishman, Tom
cf4259a4-0eef-4975-9c9d-a2c3d594f989
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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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), 1514-1523. (doi:10.1002/pon.5432).

Record type: Article

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.

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pon.5432 - Version of Record
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More information

Accepted/In Press date: 14 May 2020
e-pub ahead of print date: 27 May 2020
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
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Gareth Griffiths: ORCID iD orcid.org/0000-0002-9579-8021

Catalogue record

Date deposited: 05 Aug 2020 16:31
Last modified: 09 Jan 2022 03:47

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Contributors

Author: Deborah Fenlon
Author: Tom Maishman
Author: Laura Day
Author: Jacqueline Nuttall
Author: Carl May ORCID iD
Author: Mary Ellis
Author: James Raftery
Author: Lesley Turner
Author: Jo Fields
Author: Myra S. Hunter

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