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Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
May 1, 2020
Miek C Jong et al. (7 authors)
Journal ArticleMeta-AnalysisSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of massage as a complementary therapy for pain management in children with cancer.

Results Summary

The meta-analysis found that massage demonstrated no significant effect on pain compared with standard care (MD, -0.77; 95% CI, -1.82, 0.28; P=0.15). It was included as one of five modalities in the decision aid for CAM treatment of pain.

Population

Parents of children with cancer.

Effective Dosage

Not available

Duration

Not available

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
hypnotherapy
decrease
cancer-related procedural pain
children with cancer
MD, - 1.37; 95% CI, - 1.60, - 1.15; P < 0.00001
significantly reduced
#1
hypnotherapy
decrease
cancer-related procedural pain
children with cancer
MD, - 1.13; 95% CI, - 1.34, - 0.94; P < 0.00001
significantly reduced
#2
massage
no change
pain
children with cancer
MD, - 0.77; 95% CI, - 1.82, 0.28; P = 0.15
demonstrating no effect
#3
Abstract

PURPOSE: To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use of complementary and alternative medicine (CAM) for cancer care. METHODS: This study had a mixed research design. The needs of parents were investigated by survey and focus group. A systematic review and meta-analysis were performed on the effectiveness of CAM using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatment for pain was developed. RESULTS: Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broad spectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11 randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Meta-analysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared with standard care (MD, - 1.37; 95% CI, - 1.60, - 1.15; P < 0.00001) and attention control (MD, - 1.13; 95% CI, - 1.34, - 0.94; P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, - 0.77; 95% CI, - 1.82, 0.28; P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a website-based decision aid. CONCLUSIONS: An evidence-based decision aid was developed to support parents of children with cancer in making decisions about CAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaints and to evaluate its use in practice.

Medical Subject Headings (MeSH)
ChildChild, PreschoolComplementary TherapiesDecision MakingDecision Support TechniquesEvidence-Based MedicineFocus GroupsHumansHypnosisMaleMassageMusic TherapyNeoplasmsPainPain ManagementParentsSurveys and Questionnaires
Study Links
Quality Scores
SafetyNot Assessed
Efficacy30/10
Quality85/10
Citation Metrics
Total Citations15
Citations/Year3.0
Relative Citation Ratio1.34
NIH Percentile61%
Research Impact Scores
APT Score0.75
Weight Score2.47
Normalized Score0.49
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