Patient-Reported Depression and Anxiety in Patients With Cancer Improves Following Reduction in Anemia-Related Fatigue With Darbepoetin Alfa Therapy

2.50
Hdl Handle:
http://hdl.handle.net/10755/165408
Category:
Abstract
Type:
Presentation
Title:
Patient-Reported Depression and Anxiety in Patients With Cancer Improves Following Reduction in Anemia-Related Fatigue With Darbepoetin Alfa Therapy
Author(s):
Amorajabi, M.; Tcheckmedyian, S.; Kallich, J.
Author Details:
M. Amorajabi, Pacific Shores Medical Group, Long Beach, California, USA; S. Tcheckmedyian; J. Kallich
Abstract:
INTRODUCTION: Fatigue is associated with the anemia that is frequently observed in patients with cancer, and can have a greater impact on patients than pain, potentially decreasing emotional well-being and reducing health-related quality of life (HRQOL) (Vogelzang 1997; Ludwig 1998). Treatment of anemia with erythropoietic agents has been shown to reduce fatigue and improve HRQOL (Demetri 1998). This analysis investigated the psychologic outcomes associated with treating anemia. METHODS: Anemic (hemoglobin <=11 g/dL) patients with cancer undergoing chemotherapy, who were enrolled in two international clinical trials, received 12 weeks of treatment with darbepoetin alfa, epoetin alfa, or placebo (n=607). Darbepoetin alfa has a longer serum half-life and greater biologic activity than epoetin alfa, allowing less-frequent administration. The psychologic status of patients was assessed using the Brief Symptom Inventory (BSI) Depression and Anxiety scales, and the Functional Assessment of Cancer Therapy (FACT)-General scale (including fatigue as well as functional, physical, emotional, and social/family well-being scales). RESULTS: Patients with a >= 2 g/dL increase in hemoglobin (n=200) reported a mean change in FACT-Fatigue scale score of 3.8 (95% CI: 2.2, 5.5), compared with only 1.0 (95% CI: -0.1, 2.0) for patients with a <2 g/dL increase in hemoglobin (n=402). Patients reporting clinically important reductions in fatigue (>=3-point increase in FACT-Fatigue scale score) exhibited a reduction in depression and anxiety, as reflected in the change from baseline of -5.1 (95% CI: -6.8, -3.5) (n=271) and -6.1 (95% CI: -7.7, -4.5) (n=270) in the BSI Depression and Anxiety scale scores, respectively. Patients without clinically important reductions in fatigue (<3-point increase in FACT-Fatigue scale score) exhibited an increase in depression and anxiety, as reflected in the change from baseline of 3.1 (95% CI: 1.5, 4.7) (n=333) and 1.6 (95% CI: 0.1, 3.1) (n=335) in the BSI Depression and Anxiety scale scores, respectively. Change in FACT-Fatigue score was significantly correlated with change in BSI Depression score (r=-0.3495; p<0.001) and BSI Anxiety score (r=-0.3529; p<0.001). Clinically important reductions in fatigue were also associated with improvements in emotional well-being and overall health scores. CONCLUSIONS: These findings indicate that the treatment of anemia in patients with cancer reduces fatigue, which subsequently reduces depression and anxiety and improves emotional well-being and overall health. It is therefore important to recognize and appropriately manage anemia-related fatigue in patients with cancer.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2003
Conference Name:
28th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Denver, Colorado, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePatient-Reported Depression and Anxiety in Patients With Cancer Improves Following Reduction in Anemia-Related Fatigue With Darbepoetin Alfa Therapyen_GB
dc.contributor.authorAmorajabi, M.en_US
dc.contributor.authorTcheckmedyian, S.en_US
dc.contributor.authorKallich, J.en_US
dc.author.detailsM. Amorajabi, Pacific Shores Medical Group, Long Beach, California, USA; S. Tcheckmedyian; J. Kallichen_US
dc.identifier.urihttp://hdl.handle.net/10755/165408-
dc.description.abstractINTRODUCTION: Fatigue is associated with the anemia that is frequently observed in patients with cancer, and can have a greater impact on patients than pain, potentially decreasing emotional well-being and reducing health-related quality of life (HRQOL) (Vogelzang 1997; Ludwig 1998). Treatment of anemia with erythropoietic agents has been shown to reduce fatigue and improve HRQOL (Demetri 1998). This analysis investigated the psychologic outcomes associated with treating anemia. METHODS: Anemic (hemoglobin &lt;=11 g/dL) patients with cancer undergoing chemotherapy, who were enrolled in two international clinical trials, received 12 weeks of treatment with darbepoetin alfa, epoetin alfa, or placebo (n=607). Darbepoetin alfa has a longer serum half-life and greater biologic activity than epoetin alfa, allowing less-frequent administration. The psychologic status of patients was assessed using the Brief Symptom Inventory (BSI) Depression and Anxiety scales, and the Functional Assessment of Cancer Therapy (FACT)-General scale (including fatigue as well as functional, physical, emotional, and social/family well-being scales). RESULTS: Patients with a &gt;= 2 g/dL increase in hemoglobin (n=200) reported a mean change in FACT-Fatigue scale score of 3.8 (95% CI: 2.2, 5.5), compared with only 1.0 (95% CI: -0.1, 2.0) for patients with a &lt;2 g/dL increase in hemoglobin (n=402). Patients reporting clinically important reductions in fatigue (&gt;=3-point increase in FACT-Fatigue scale score) exhibited a reduction in depression and anxiety, as reflected in the change from baseline of -5.1 (95% CI: -6.8, -3.5) (n=271) and -6.1 (95% CI: -7.7, -4.5) (n=270) in the BSI Depression and Anxiety scale scores, respectively. Patients without clinically important reductions in fatigue (&lt;3-point increase in FACT-Fatigue scale score) exhibited an increase in depression and anxiety, as reflected in the change from baseline of 3.1 (95% CI: 1.5, 4.7) (n=333) and 1.6 (95% CI: 0.1, 3.1) (n=335) in the BSI Depression and Anxiety scale scores, respectively. Change in FACT-Fatigue score was significantly correlated with change in BSI Depression score (r=-0.3495; p&lt;0.001) and BSI Anxiety score (r=-0.3529; p&lt;0.001). Clinically important reductions in fatigue were also associated with improvements in emotional well-being and overall health scores. CONCLUSIONS: These findings indicate that the treatment of anemia in patients with cancer reduces fatigue, which subsequently reduces depression and anxiety and improves emotional well-being and overall health. It is therefore important to recognize and appropriately manage anemia-related fatigue in patients with cancer.en_GB
dc.date.available2011-10-27T12:18:00Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:18:00Z-
dc.conference.date2003en_US
dc.conference.name28th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationDenver, Colorado, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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