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Factors that shape preference for acupuncture or cognitive behavioral therapy for the treatment of insomnia in cancer patients

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Abstract

Purpose

Patient preference is an essential component of patient-centered supportive cancer care; however, little is known about the factors that shape preference for treatment. This study sought to understand what factors may contribute to patient preference for two non-pharmacological interventions, acupuncture or cognitive behavioral therapy for insomnia (CBT-I).

Methods

We conducted individual, open-ended, semi-structured interviews among cancer survivors who had completed active treatment and met the diagnostic criteria for insomnia disorder. Two forms of codes were used for analysis: a priori set of codes derived from the key ideas and a set of codes that emerged from the data.

Results

Among 53 participants, the median age was 60.7 (range 27–83), 30 participants (56.6%) were female, and 18 (34%) were non-white. We identified three themes that contributed to an individual’s treatment preference: perception of the treatment’s evidence base, experience with the treatment, and consideration of personal factors. Participants gave preference to the treatment perceived as having stronger evidence. Participants also reflected on positive or negative experiences with both of the interventions, counting their own experiences, as well as those of trusted sources. Lastly, participants considered their own unique circumstances and factors such as the amount of work involved, fit with personality, or fit with their “type” of insomnia.

Conclusions

Knowledge of the evidence base, past experience, and personal factors shaped patient preference regardless of whether they accurately represent the evidence. Acknowledging these salient factors may help inform patient-centered decision-making and care.

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Acknowledgements

Research reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER-1403-14292). This manuscript is also supported in part by a grant from the National Institutes of Health/National Cancer Institute Cancer Center (P30 CA008748). The statements presented in this article are solely the responsibility of the author(s) and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee. Sincere thanks go to the CHOICE Study Patient Advisory Board members (Bill Barbour, Winifred Chain, Linda Geiger, Donna-Lee Lista, Jodi MacLeod, Alice McAllister, Hilma Maitland, and Edward Wolff), the participants, and clinical staff for their support of this study.

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Authors and Affiliations

  1. Departments of Psychology and Oncology, Memorial University of Newfoundland, St. John’s, NL, Canada

    Sheila N. Garland

  2. Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Whitney Eriksen, Sarah Song & Frances K. Barg

  3. Geisinger Commonwealth School of Medicine, Scranton, PA, USA

    Joshua Dearing

  4. Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Philip Gehrman

  5. The Bendheim Center for Integrative Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Jun J. Mao

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  1. Sheila N. Garland
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  2. Whitney Eriksen
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Correspondence to Sheila N. Garland.

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This research was supported by the sources acknowledged above. The funders had no part in the collection, analysis, or interpretation of the data. The corresponding author has full control of all primary data and we agree to allow the journal to review this data if requested.

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Garland, S.N., Eriksen, W., Song, S. et al. Factors that shape preference for acupuncture or cognitive behavioral therapy for the treatment of insomnia in cancer patients. Support Care Cancer 26, 2407–2415 (2018). https://doi.org/10.1007/s00520-018-4086-4

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