Acupuncture in the Treatment of Cancer-Related Psychological Symptoms: A Closer Look at Efficacy and...
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as PubMed are currently regularly used, the addition of less efficient databases such as Google Scholar and Scopus is re- commended to reduce retrieval bias based on time or place of publication. Contact: Lesley Ward, [email protected] P05.26 LB Measuring Botanical Supplement Use among Hispanics/ Latinos in the United States: A Comparison of Methods in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Keturah Faurot (1), Anna-Maria Siega-Riz (2), Paula Gardiner (3), Jose ´ O. Rivera (4), Laura Young (5), Hector Gonza ´lez (6), Janice Barnhart (7), Sheila Casteneda (8), Diana Chirinos (9), Martha Daviglus (10), Rebeca Espinoza (8), Gregory Talavera (8), Linda Van Horn (11), Eric Whitsel (2), M. Larissa Avile ´s- Santa (12) (1) University of North Carolina Epidemiology/Physical Med- icine & Rehabilitation, Chapel Hill, NC, USA (2) University of North Carolina Epidemiology, Chapel Hill, NC, USA (3) Boston University Medical Center, Boston, MA, USA (4) University of Texas, El Paso, TX, USA (5) University of North Carolina School of Medicine, Chapel Hill, NC, USA (6) Michigan State University, East Lansing, MI, USA (7) Albert Einstein College of Medicine, Bronx, NY, USA (8) San Diego State University, San Diego, CA, USA (9) University of Miami, Coral Gables, FL, USA (10) University of Illinois-Chicago, Chicago, IL, USA (11) Northwestern University, Chicago, IL, USA (12) National Heart, Lung, and Blood Institute, Bethesda, MD, USA Purpose: Conventional assessment methods may underestimate the use of botanical supplements in ethnic minorities who re- portedly consume teas rather than encapsulated forms. The purpose of this study was to examine and compare methodology for botanical and non-vitamin non-mineral (NVNM) dietary supplement measurement in a sample of Hispanics/Latinos in the United States (US). Methods: At baseline (2008–2011), supplements were assessed with three methods in HCHS/SOL (n = 15,673): 1) past 4-week medication inventory; 2) past 30-day dietary supplement inter- view (DI); and 3) two 24-hour dietary recalls. Prevalence esti- mates for medication inventory, DI, and recalls were adjusted with sampling and nonresponse weights and age-standardized to the US 2010 Census. Concordance statistics compared the medication inventory and DI. Results: Self-reported prevalence of NVNM and botanical supplement use was markedly higher for the DI as compared to the medication interview—for NVNM (including botanical) supplements (24.6 vs. 12.9%) and for botanicals alone (9.4 vs. 4.4%). Concordance between the two measures was fair/ moderate (Kappa 0.30–0.57), but negative agreement was high ( ‡ 0.88). With the addition of teas and raw botanicals from the dietary recalls, prevalence increased by 34% for NVNM sup- plements and 127% for botanicals. In the DI data (without re- calls), the most common supplement ingredients mirrored those widespread in the general public: omega-3 fatty acids (e.g., fish oil, flax oil) (9.7%), lutein (9.6%), and lycopene (10.5%). Commonly reported botanical ingredients were ginseng (2.6%), ginkgo (2.6%), garlic (1.7%), and extracts of fruits (4.2%) and vegetables (2.3%). In 24-hour recalls, chamomile tea was more often reported (1.9%) than in the DI (0.2%) Conclusion: Different botanical supplement measurement methodologies yielded different results among Hispanics/Latinos in HCHS/SOL—measurement methodology should be considered when evaluating study results. Among Hispanics/Latinos, com- prehensive botanical use ascertainments require multiple assess- ments, including those that capture raw botanicals. Because botanicals may have adverse effects and interact with medica- tions, accurate measurement is critical. Contact: Keturah Faurot, [email protected] P05.27 LB Acupuncture in the Treatment of Cancer-Related Psychological Symptoms: A Closer Look at Efficacy and Methodology Nadia Haddad (1), Oxana Palesh (1) (1) Stanford University School of Medicine, Department of Psychiatry & Behavioral Sciences, Stanford, CA, USA Purpose: Cancer patients/survivors are high utilizers of acu- puncture. Additionally, they experience a high prevalence of psychological symptoms such as depression, anxiety, sleep disturbance, and impairment in quality of life. Non-pharmaco- logic interventions for these symptoms are of interest given the high chemical burden resulting from cancer treatments. Methods: We reviewed studies from 2000–2013 evaluating acupuncture for depression, anxiety, sleep disturbance and quality of life in cancer patients/survivors, with attention to acupuncture efficacy and methodology. Twelve studies met re- view criteria: 1) original research utilizing acupuncture, and 2) cancer-associated psychological symptoms (as above) as pri- mary or secondary outcomes. Results: All 12 studies (total participants N = 933) had a positive signal for acupuncture in the treatment of these psychological symptoms. However, only 2 of 12 studies reported all essential aspects of acupuncture methodology as outlined by the 2010 Standards for Reporting Interventions in Controlled Trials of Acupuncture guidelines. The most commonly omitted infor- mation in these studies was: 1) details of needle administration (4/12 studies), 2) rationale for acupuncture point selection (6/12 studies), and 3) training level of acupuncture provider (6/12 studies). There was frequent non-reporting of statistical param- eters important for evaluating effect sizes and significance. Conclusion: The regular omission of methodological data sug- gests that the heterogeneity of acupuncture administration is not being adequately evaluated. We propose a shift in methodology such that study design 1) clarifies the role of Chinese medical theory in designing studies, which involves a holistic accounting of symptoms rather than the single-symptom focus of modern scientific trials, 2) determines the role of needling technique, such as vigorous stimulation of needles to obtain ‘‘De Qi’’ (a specific needling sensation), and 3) evaluates the characteristics of potential responders and non-responders to acupuncture. More research is needed, but acupuncture may provide an ef- fective and well-tolerated alternative to pharmacological inter- ventions for management of psychological symptoms in cancer. Contact: Nadia Haddad, MD, MS, L.Ac, nhaddad@stanford .edu A136
Transcript of Acupuncture in the Treatment of Cancer-Related Psychological Symptoms: A Closer Look at Efficacy and...
as PubMed are currently regularly used, the addition of lessefficient databases such as Google Scholar and Scopus is re-commended to reduce retrieval bias based on time or place ofpublication.Contact: Lesley Ward, [email protected]
P05.26 LBMeasuring Botanical Supplement Use among Hispanics/Latinos in the United States: A Comparison of Methodsin the Hispanic Community Health Study/Studyof Latinos (HCHS/SOL)
Keturah Faurot (1), Anna-Maria Siega-Riz (2), Paula Gardiner(3), Jose O. Rivera (4), Laura Young (5), Hector Gonzalez (6),Janice Barnhart (7), Sheila Casteneda (8), Diana Chirinos (9),Martha Daviglus (10), Rebeca Espinoza (8), Gregory Talavera(8), Linda Van Horn (11), Eric Whitsel (2), M. Larissa Aviles-Santa (12)
(1) University of North Carolina Epidemiology/Physical Med-icine & Rehabilitation, Chapel Hill, NC, USA(2) University of North Carolina Epidemiology, Chapel Hill,NC, USA(3) Boston University Medical Center, Boston, MA, USA(4) University of Texas, El Paso, TX, USA(5) University of North Carolina School of Medicine, ChapelHill, NC, USA(6) Michigan State University, East Lansing, MI, USA(7) Albert Einstein College of Medicine, Bronx, NY, USA(8) San Diego State University, San Diego, CA, USA(9) University of Miami, Coral Gables, FL, USA(10) University of Illinois-Chicago, Chicago, IL, USA(11) Northwestern University, Chicago, IL, USA(12) National Heart, Lung, and Blood Institute, Bethesda, MD,USA
Purpose: Conventional assessment methods may underestimatethe use of botanical supplements in ethnic minorities who re-portedly consume teas rather than encapsulated forms. Thepurpose of this study was to examine and compare methodologyfor botanical and non-vitamin non-mineral (NVNM) dietarysupplement measurement in a sample of Hispanics/Latinos inthe United States (US).Methods: At baseline (2008–2011), supplements were assessedwith three methods in HCHS/SOL (n = 15,673): 1) past 4-weekmedication inventory; 2) past 30-day dietary supplement inter-view (DI); and 3) two 24-hour dietary recalls. Prevalence esti-mates for medication inventory, DI, and recalls were adjustedwith sampling and nonresponse weights and age-standardized tothe US 2010 Census. Concordance statistics compared themedication inventory and DI.Results: Self-reported prevalence of NVNM and botanicalsupplement use was markedly higher for the DI as comparedto the medication interview—for NVNM (including botanical)supplements (24.6 vs. 12.9%) and for botanicals alone (9.4vs. 4.4%). Concordance between the two measures was fair/moderate (Kappa 0.30–0.57), but negative agreement was high( ‡ 0.88). With the addition of teas and raw botanicals from thedietary recalls, prevalence increased by 34% for NVNM sup-plements and 127% for botanicals. In the DI data (without re-calls), the most common supplement ingredients mirrored thosewidespread in the general public: omega-3 fatty acids (e.g., fishoil, flax oil) (9.7%), lutein (9.6%), and lycopene (10.5%).Commonly reported botanical ingredients were ginseng (2.6%),
ginkgo (2.6%), garlic (1.7%), and extracts of fruits (4.2%) andvegetables (2.3%). In 24-hour recalls, chamomile tea was moreoften reported (1.9%) than in the DI (0.2%)Conclusion: Different botanical supplement measurementmethodologies yielded different results among Hispanics/Latinosin HCHS/SOL—measurement methodology should be consideredwhen evaluating study results. Among Hispanics/Latinos, com-prehensive botanical use ascertainments require multiple assess-ments, including those that capture raw botanicals. Becausebotanicals may have adverse effects and interact with medica-tions, accurate measurement is critical.Contact: Keturah Faurot, [email protected]
P05.27 LBAcupuncture in the Treatment of Cancer-RelatedPsychological Symptoms: A Closer Look at Efficacyand Methodology
Nadia Haddad (1), Oxana Palesh (1)
(1) Stanford University School of Medicine, Department ofPsychiatry & Behavioral Sciences, Stanford, CA, USA
Purpose: Cancer patients/survivors are high utilizers of acu-puncture. Additionally, they experience a high prevalence ofpsychological symptoms such as depression, anxiety, sleepdisturbance, and impairment in quality of life. Non-pharmaco-logic interventions for these symptoms are of interest given thehigh chemical burden resulting from cancer treatments.Methods: We reviewed studies from 2000–2013 evaluatingacupuncture for depression, anxiety, sleep disturbance andquality of life in cancer patients/survivors, with attention toacupuncture efficacy and methodology. Twelve studies met re-view criteria: 1) original research utilizing acupuncture, and 2)cancer-associated psychological symptoms (as above) as pri-mary or secondary outcomes.Results: All 12 studies (total participants N = 933) had a positivesignal for acupuncture in the treatment of these psychologicalsymptoms. However, only 2 of 12 studies reported all essentialaspects of acupuncture methodology as outlined by the 2010Standards for Reporting Interventions in Controlled Trials ofAcupuncture guidelines. The most commonly omitted infor-mation in these studies was: 1) details of needle administration(4/12 studies), 2) rationale for acupuncture point selection (6/12studies), and 3) training level of acupuncture provider (6/12studies). There was frequent non-reporting of statistical param-eters important for evaluating effect sizes and significance.Conclusion: The regular omission of methodological data sug-gests that the heterogeneity of acupuncture administration is notbeing adequately evaluated. We propose a shift in methodologysuch that study design 1) clarifies the role of Chinese medicaltheory in designing studies, which involves a holistic accountingof symptoms rather than the single-symptom focus of modernscientific trials, 2) determines the role of needling technique,such as vigorous stimulation of needles to obtain ‘‘De Qi’’ (aspecific needling sensation), and 3) evaluates the characteristicsof potential responders and non-responders to acupuncture.More research is needed, but acupuncture may provide an ef-fective and well-tolerated alternative to pharmacological inter-ventions for management of psychological symptoms in cancer.Contact: Nadia Haddad, MD, MS, L.Ac, [email protected]
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