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A Randomized Controlled Trial of Hypnosis to Manage Musculoskeletal Pain in Breast Cancer Survivors Taking Aromatase
Guy H Montgomery1, Julie B Schnur1, Amy Tiersten2
1Center for Behavioral Oncology, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
The aim of this study was to test the efficacy of a three-session hypnosis intervention to manage musculoskeletal pain (MSP) in breast cancer survivors taking aromatase inhibitors (AIs). We hypothesized that patients in the hypnosis group would have lower levels of pain than patients in an attention control group. A secondary outcome was to examine intervention effects on AI adherence. Patients (n=154) were randomly assigned to a hypnosis (n=76; mean) or to an attention control (n=78; mean) group. MSP was measured at five time points (baseline, 3, 6, 9, and 12 months) using the BPI-SF (severity, primary outcome), the BPI-SF (interference), the WOMAC, the AUSCAN and the BCPT-MS. AI adherence was measured using eCAPs and self-report (MARS). The hypnosis group had significantly lower BPI-SF severity (p< 0.01) and interference (p< 0.03) scores across assessment points. The AUSCAN [total (p< 0.01), pain (p< 0.01), stiffness (p< 0.04), and function (p< 0.04)] and the BCPT-MS (p< 0.001) scales showed similar results in favor of hypnosis. WOMAC pain (p< 0.02) and stiffness (p< 0.01) subscales were also in favor of the hypnosis group, but differences on WOMAC function were non-significant (p >0.11). AI adherence scores did not differ between the groups (eCAP p >0.80, MARS ps >0.18). Results support hypnosis as efficacious for controlling MSP in breast cancer survivors taking AIs. Hypnosis is brief, has no specific side-effects, can be taught to patients to use on their own, and its beneficial effects persist long after the last intervention session.
The aim of this study was to test the efficacy of a three-session hypnosis intervention to manage musculoskeletal pain (MSP) in breast cancer survivors taking aromatase inhibitors (AIs). We hypothesized that patients in the hypnosis group would have lower levels of pain than patients in an attention control group. A secondary outcome was to examine intervention effects on AI adherence. Patients (n=154) were randomly assigned to a hypnosis (n=76; mean) or to an attention control (n=78; mean) group. MSP was measured at five time points (baseline, 3, 6, 9, and 12 months) using the BPI-SF (severity, primary outcome), the BPI-SF (interference), the WOMAC, the AUSCAN and the BCPT-MS. AI adherence was measured using eCAPs and self-report (MARS). The hypnosis group had significantly lower BPI-SF severity (p< 0.01) and interference (p< 0.03) scores across assessment points. The AUSCAN [total (p< 0.01), pain (p< 0.01), stiffness (p< 0.04), and function (p< 0.04)] and the BCPT-MS (p< 0.001) scales showed similar results in favor of hypnosis. WOMAC pain (p< 0.02) and stiffness (p< 0.01) subscales were also in favor of the hypnosis group, but differences on WOMAC function were non-significant (p >0.11). AI adherence scores did not differ between the groups (eCAP p >0.80, MARS ps >0.18). Results support hypnosis as efficacious for controlling MSP in breast cancer survivors taking AIs. Hypnosis is brief, has no specific side-effects, can be taught to patients to use on their own, and its beneficial effects persist long after the last intervention session.
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