Lee, S., Jerng, U.M., Liu, Y., Kang, J.W., Nam, D., & Lee, J. (2014). The effectiveness and safety of moxibustion for treating cancer-related fatigue: A systematic review and meta-analyses. Supportive Care in Cancer, 22, 1429–1440. 

DOI Link

Purpose

STUDY PURPOSE: To evaluate the current evidence for the safety and efficacy of moxibustion in patients with cancer-related fatigue (CRF)
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: A total of 18 databases were used including MEDLINE, Embase, Cochrane Library, CINAHL, AMED, and PsycINFO. Three Chinese databases were used including the China National Knowledge Infrastructure, Wanfang, and VIP. One Japanese database, Japan Science and Technology Information Aggregator Electronic, was used, and eight Korean databases were used including the Korean Association of Medical Journal Edition, Korean Medical Database, Korean Studies Information Service System, and the National Discovery for Science Leaders.
 
INCLUSION CRITERIA: Randomized, controlled trials, full articles, and abstracts; no language or publication restrictions; only data from the first period in randomized cross-over trials
 
EXCLUSION CRITERIA: Nonrandomized, controlled trials, uncontrolled clinical trials (case studies), and qualitative studies

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 1,022 (1,018 excluded)
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Three primary researchers reviewed and discussed the inclusion/exclusion of studies, extracted and managed data, and assessed risk of bias and reporting quality of included studies. Research expert was resolved by arbiter should primary researchers not be able to agree. 

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 4 
 
TOTAL PATIENTS INCLUDED IN REVIEW = 374
 
SAMPLE RANGE ACROSS STUDIES: 30–180 patients
 
KEY SAMPLE CHARACTERISTICS: Multiple site-specific cancers, stages I–IV; lack of other sample characteristics provided

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

Insufficient data to make recommendations regarding safety or efficacy of moxibustion on fatigue among Chinese patients with cancer

Conclusions

Insufficient data to make recommendations regarding safety or efficacy of moxibustion on fatigue among Chinese patients with cancer

Limitations

  • High risk of bias among studies (CONCERT and STRICTA)
  • Low quality of reporting among studies
  • Findings not generalizable (all subjects from inpatient Chinese population)
  • Use of daily treatment schedules
  • Lack of placebo or sham controls
  • Methodological flaws
  • Lack of blinding procedures
  • Single measure of fatigue (Piper Fatigue Scale)
  • Mention of adverse effects omitted with exception of one case of blistering.

Nursing Implications

Techniques of moxibustion requires specialized training not usually available in United States. Access to qualified practitioners, lack of an appropriate placebo or sham control, and frequency of treatment administration to outpatients would make additional studies of safety and efficacy difficult for nurse researchers to conduct.

Legacy ID

4793