Browsing by Person "Fallon, Marie T."

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A randomized, feasibility trial of an exercise and nutrition‐based rehabilitation programme (ENeRgy) in people with cancer
(Wiley, 2021-10-05) Hall, Charlie C.; Skipworth, Richard J.E.; Blackwood, Honor; Brown, Duncan; Cook, Jane; Diernberger, Katharina; Dixon, Elizabeth; Gibson, Valerie; Graham, Catriona; Hall, Peter; Haraldsdottir, Erna; Hopkinson, Jane; Lloyd, Anna; Maddocks, Matthew; Norris, Lucy; Tuck, Sharon; Fallon, Marie T.; Laird, Barry J.A.
Background: Despite rehabilitation being increasingly advocated for people living with incurable cancer, there is limited evidence supporting efficacy or component parts. The progressive decline in function and nutritional in this population would support an approach that targets these factors. This trial aimed to assess the feasibility of an exercise and nutrition based rehabilitation programme in people with incurable cancer. Methods: We randomized community dwelling adults with incurable cancer to either a personalized exercise and nutrition based programme (experimental arm) or standard care (control arm) for 8 weeks. Endpoints included feasibility, quality of life, physical activity (step count), and body weight. Qualitative and health economic analyses were also included. Results: Forty‐five patients were recruited (23 experimental arm, 22 control arm). There were 26 men (58%), and the median age was 78 years (IQR 69–84). At baseline, the median BMI was 26 kg/m2 (IQR: 22–29), and median weight loss in the previous 6 months was 5% (IQR: −12% to 0%). Adherence to the experimental arm was >80% in 16/21 (76%) patients. There was no statistically significant difference in the following between trial arms: step count − median % change from baseline to endpoint, per trial arm (experimental −18.5% [IQR: −61 to 65], control 5% [IQR: −32 to 50], P = 0.548); weight − median % change from baseline to endpoint, per trial arm (experimental 1%[IQR: −3 to 3], control −0.5% [IQR: −3 to 1], P = 0.184); overall quality of life − median % change from baseline to endpoint, per trial arm (experimental 0% [IQR: −20 to 19], control 0% [IQR: −23 to 33], P = 0.846). Qualitative findings observed themes of capability, opportunity, and motivation amongst patients in the experimental arm. The mean incremental cost of the experimental arm versus control was £‐319.51 [CI −7593.53 to 6581.91], suggesting the experimental arm was less costly. Conclusions: An exercise and nutritional rehabilitation intervention is feasible and has potential benefits for people with incurable cancer. A larger trial is now warranted to test the efficacy of this approach.
Chronic pelvic pain in women: an embedded qualitative study to evaluate the perceived benefits of the meridian balance method electro-acupuncture treatment, health consultation and National Health Service standard care
(Sage Publications, 2018-11-21) Chong, Ooi Thye; Critchley, Hilary O. D.; Horne, Andrew W.; Fallon, Marie T.; Haraldsdottir, Erna
Introduction: Chronic pelvic pain (CPP) – defined as intermittent or constant pain in the lower abdomen or pelvis of at least 6 months’ duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy – is estimated to affect 6–27% of women worldwide. In the United Kingdom, over 1 million women suffer from CPP, which has been highlighted as a key area of unmet need. Current medical treatments for CPP are often associated with unacceptable side effects. A specific style of acupuncture, the meridian balance method electro-acupuncture (BMEA) and traditional Chinese medicine health consultation (TCM HC (BMEA + TCM HC = BMEA treatment)), may be effective for CPP in women. Aim: Three focus group discussions and semi-structured telephone interviews were embedded in a randomised controlled feasibility trial to gain in-depth description of the perceived benefits of the participants’ respective interventions. Methods: Women with CPP were randomised into the BMEA treatment, TCM HC or National Health Service standard care (NHS SC). Focus group discussions were recorded, transcribed and analysed thematically. Semi-structured telephone interviews were conducted post focus group discussions. Findings: A total of 30 women were randomised into BMEA treatment, TCM HC or NHS SC. A total of 11 participants attended the three focus group discussions. Thematic analysis of focus group discussions showed: a perceived pain reduction, enhanced sleep, energy level and sense of well-being in the BMEA treatment and TCM HC groups; a dislike for the adverse effects of medications, frustration at the lack of effective treatment, heavy reliance on medications and services that are helpful, in the NHS SC group. Semi-structured telephone interviews showed that the methodology was acceptable to the participants. Conclusion: The embedded focus group discussions captured the rich and complex narratives of the participants and provided insights into the perceived benefits of the BMEA treatment, TCM HC and NHS SC interventions.
Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study
(2007-09-05) Storey, D. J.; Waters, Rachael A.; Hibberd, Carina J.; Rush, Robert; Cargill, A.; Wall, L. R.; Fallon, Marie T.; Strong, V.; Walker, J.; Sharpe, M.
Background: Fatigue is associated with cancer and its treatment but we know little about how many and which patients suffer fatigue of clinical severity. We aimed to determine the prevalence of clinically relevant fatigue (CRF) and its associations in outpatients with various cancer diagnoses. Patients and methods: A survey of outpatients with colorectal, breast, gynaecological, genitourinary, sarcoma, melanoma and miscellaneous tumours at a regional cancer centre. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) fatigue subscale and the Hospital Anxiety and Depression Scale (HADS). These self-report data were linked to demographic and clinical variables. Data were available on 2867 outpatients. Results: The prevalence of CRF (EORTC fatigue subscale ‡40) was 32% (95% confidence interval 31–34%). The variables independently associated with CRF were primary cancer site, having disease present, type of cancer treatment and emotional distress (total HADS score ‡15). Emotional distress had the strongest association with fatigue but half the cases of CRF were not distressed. Conclusion: CRF is common in cancer outpatients and is associated with type of disease and treatment, as well as with emotional distress. The association between CRF and emotional distress is strong but they are not equivalent conditions. Key words: associations, cancer, fatigue, predictors, prevalence, treatment
Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study
(2007-02-20) Strong, V.; Waters, Rachael A.; Hibberd, Carina J.; Rush, Robert; Cargill, A.; Storey, D. J.; Walker, J.; Wall, L.; Fallon, Marie T.; Sharpe, M.
To: (1) estimate the prevalence of clinically significant emotional distress in patients attending a cancer outpatient department and (2) determine the associations between distress and demographic and clinical variables, we conducted a survey of outpatients attending selected clinics of a regional cancer centre in Edinburgh, UK. Patients completed the Hospital Anxiety and Depression Scale (HADS) on touch-screen computers and the scores were linked to clinical variables on the hospital database. Nearly one quarter of the cancer outpatients 674 out of 3071 (22%; 95% confidence interval (CI) 20–23%) met our criterion for clinically significant emotional distress (total HADS score 15 or more). Univariate analysis identified the following statistically significant associations: age <65, female gender, cancer type and extent of disease. Multivariate analysis indicated that age <65 (odds ratio 1.41; 95% CI 1.18–1.69), female gender (odds ratio 1.58; 95% CI 1.31–1.92) and active disease (odds ratio 1.72; 95% CI 1.43–2.05) but not cancer diagnosis, were the independent predictors of clinically significant emotional distress. Services to treat distress in cancer patients should be organised to target patients by characteristics other than their cancer diagnosis.
A randomised, phase II, unblinded trial of an Exercise and Nutrition-based Rehabilitation programme (ENeRgy) versus standard care in patients with cancer: Feasibility trial protocol
(BioMed Central, 2018-12-27) Hall, Charlie C.; Norris, Lucy; Dixon, Liz; Cook, Jane; Maddocks, Matthew; Graham, Catriona; Tuck, Sharon; Haraldsdottir, Erna; Brown, Duncan; Lloyd, Anna; Finucane, Anne; Hall, Peter; Diernberger, Katharina; Skipworth, Richard J. E.; Fallon, Marie T.; Laird, Barry J.
Patients are living longer with incurable cancer [1] such that in many cases, cancer is likened to a chronic disease [2, 3, 4]. This development has wide-ranging implications for both patients and wider society, with increased longevity comes increased morbidity and associated socio-economic burden [5, 6]. Primary cost drivers for patients with advanced cancer are hospitalisation, GP and domiciliary visits [7]. Rehabilitation has been advocated as one such way of optimising the function and quality of life in this group of patients [8]; however, the optimal components of a rehabilitation model for patients with incurable cancer remain to be elucidated...
A systematic review examining nutrition support interventions in patients with incurable cancer
(Springer Berlin Heidelberg, 2019-07-29) Blackwood, Honor A.; Hall, Charlie C.; Balstad, Trude R.; Solheim, Tora S.; Fallon, Marie T.; Haraldsdottir, Erna; Laird, Barry J.
Purpose: Recent guidelines by the European Society for Clinical Nutrition and Metabolism (ESPEN) have advocated increased attention to nutritional support in all patients with cancer: however, little is known about the optimal type of nutritional intervention. The aim of this review was to assess the current evidence for nutrition support in patients with incurable cancer. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. EMBASE, Medline and CINAHL were searched from 1990-2018. Evidence was appraised using a modified risk of bias table, based on guidance from the Cochrane Handbook for Systematic Reviews of Interventions. Results: Sixty studies were assessed of which twelve met the eligibility criteria. Eleven studies examined body composition, with six studies reporting improvements in weight. Six studies examined nutritional status with three studies reporting an improvement. Nine studies examined nutritional intake with six showing improvements including significant improvements in dietary and protein intake. Ten studies examined quality of life, with six studies reporting improvements following intervention. The most common nutritional interventions examined were nutrition counselling and dietary supplementation. Conclusions: There is moderate quality evidence to support the need for increased attention to nutrition support in patients with incurable cancer; however, despite some statistically significant results being reported the clinical effects of them were small. Key questions remain as to the optimal timing for these interventions to be implemented (e.g. cachexia stage, illness stage, timing with anticancer therapy) and the most appropriate endpoint measures.
The BMEA study: the impact of meridian balanced method electroacupuncture on women with chronic pelvic pain--a three-arm randomised controlled pilot study using a mixed-methods approach
(2015-11-01) Chong, Ooi Thye; Critchley, Hilary O. D.; Horne, Andrew W.; Elton, Robert; Haraldsdottir, Erna; Fallon, Marie T.
Introduction: Chronic pelvic pain (CPP) affects 3-4% of women worldwide. Proven treatments for CPP are limited and unsatisfactory. The meridian balance method (BM) electroacupuncture (EA) treatment (BMEA + Traditional Chinese Medicine Health Consultation (TCM HC) may be effective for CPP. Previous EA studies have demonstrated an analgesic effect. Large-scale studies on acupuncture for other chronic pain conditions suggest that patient-healthcare provider interaction might play a role in pain reduction. We propose a pilot study to explore the effectiveness of the meridian BMEA treatment in managing women with CPP to inform a future large randomised controlled trial. Methods and analysis: A 3-armed randomised controlled pilot study is proposed with an aim to recruit 30 women with CPP in National Health Service (NHS) Lothian. Randomisation will be to BMEA treatment, TCM HC or standard care (SC). Validated pain, physical and emotional functioning questionnaires will be administered to all participants at weeks 0, 4, 8 and 12. Focus group discussions will be conducted when week 12 questionnaires are completed. The primary objective is to determine, recruitment and retention rates. The secondary objectives are to assess the effectiveness and acceptability of the proposed methods of recruitment, randomisation, interventions and assessment tools. Ethics and dissemination: Ethical approval has been obtained from the Scotland Research Ethics Committee (REC 14/SS/1022). Data will be published in peer-reviewed journals and presented at international conferences.
The impact of meridian balance method electro-acupuncture treatment on chronic pelvic pain in women: a three-armed randomised controlled feasibility study using a mixed-methods approach
(SAGE Publications, 2018-05-14) Chong, Ooi Thye; Critchley, Hilary O. D.; Williams, Linda J.; Haraldsdottir, Erna; Horne, Andrew W.; Fallon, Marie T.
Introduction: Chronic pelvic pain (CPP) is estimated to affect 6%–27% of women worldwide. In the United Kingdom, over 1 million women suffer from CPP and it has been highlighted as a key area of unmet need. Standard treatments are associated with unacceptable side effects. The meridian balance method electro-acupuncture (BMEA), and traditional Chinese medicine health consultation (TCM HC) (BMEA + TCM HC = BMEA treatment) may be an effective adjunct to standard treatment. Aim: The aim of our study was to evaluate the feasibility of a future trial, to determine the effectiveness of the BMEA treatment for CPP in women. The primary objectives were to determine recruitment and retention rates. The secondary objectives were to assess the effectiveness of the BMEA treatment and acceptability of the study’s methodology. Methods: Women with CPP were randomised into BMEA treatment (group 1), TCM HC alone (group 2) (each intervention administered twice weekly for 4 weeks) or National Health Service standard care (NHS SC, group 3). Primary outcomes were assessed by the proportion of eligible participants randomised, and the proportion of randomised participants who returned follow-up questionnaires. Interventions were assessed by validated pain/physical/emotional functioning questionnaires at baseline (0), 4, 8 and 12 weeks. Focus groups and semi-structured telephone interviews were embedded in the study. Results: A total of 30 women (51% of those referred) were randomised over 8 months. Retention rates were 80% (95% confidence interval (CI): 74–96), 53% (95% CI: 36–70) and 87% (95% CI: 63–90), in groups 1, 2, and 3, respectively. Qualitative data suggested a favourable trial experience in groups 1 and 3. Discussion: Group 2 retention rate was problematic and has implications for our next trial. Conclusion: Our study suggests that a future trial to determine the effectiveness of BMEA treatment for women with CPP is feasible but with modifications to the study design.