@Article{info:doi/10.2196/jmir.7180,
author="Bruggeman-Everts, Fieke Z
and Wolvers, Marije D J
and van de Schoot, Rens
and Vollenbroek-Hutten, Miriam M R
and Van der Lee, Marije L",
title="Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the ``Fitter na kanker'' Randomized Controlled Trial",
journal="J Med Internet Res",
year="2017",
month="Oct",
day="19",
volume="19",
number="10",
pages="e336",
keywords="fatigue; cancer survivors; Internet interventions; mindfulness-based cognitive therapy; physiotherapy; accelerometry; latent growth analysis; implementation; RCT",
abstract="Background: Approximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue (CCRF). Effective and easily accessible interventions are needed for these patients. Objective: The current paper reports on the results of a 3-armed randomized controlled trial investigating the clinical effectiveness of two different guided Web-based interventions for reducing CCRF compared to an active control condition. Methods: Severely fatigued cancer survivors were recruited via online and offline channels, and self-registered on an open-access website. After eligibility checks, 167 participants were randomized via an embedded automated randomization function into: (1) physiotherapist-guided Ambulant Activity Feedback (AAF) therapy encompassing the use of an accelerometer (n=62); (2) psychologist-guided Web-based mindfulness-based cognitive therapy (eMBCT; n=55); or (3) an unguided active control condition receiving psycho-educational emails (n=50). All interventions lasted nine weeks. Fatigue severity was self-assessed using the Checklist Individual Strength - Fatigue Severity subscale (primary outcome) six times from baseline (T0b) to six months (T2). Mental health was self-assessed three times using the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule (secondary outcome). Treatment dropout was investigated. Results: Multiple group latent growth curve analysis, corrected for individual time between assessments, showed that fatigue severity decreased significantly more in the AAF and eMBCT groups compared to the psycho-educational group. The analyses were checked by a researcher who was blind to allocation. Clinically relevant changes in fatigue severity were observed in 66{\%} (41/62) of patients in AAF, 49{\%} (27/55) of patients in eMBCT, and 12{\%} (6/50) of patients in psycho-education. Dropout was 18{\%} (11/62) in AAF, mainly due to technical problems and poor usability of the accelerometer, and 38{\%} (21/55) in eMBCT, mainly due to the perceived high intensity of the program. Conclusions: Both the AAF and eMBCT interventions are effective for managing fatigue severity compared to receiving psycho-educational emails. Trial Registration: Trialregister.nl NTR3483; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3483 (Archived by WebCite at http://www.webcitation.org/6NWZqon3o)  ",
issn="1438-8871",
doi="10.2196/jmir.7180",
url="http://www.jmir.org/2017/10/e336/",
url="https://doi.org/10.2196/jmir.7180",
url="http://www.ncbi.nlm.nih.gov/pubmed/29051138"
}