Abstract
Objective
To quantify the effect of a psychoeducation-based cognitive rehabilitation intervention
on breast cancer survivors’ self-report of cognitive function and investigate the
feasibility of accrual, adherence, and multisite program delivery using secure telehealth
conferencing.
Design
Prospective, nonblinded, wait-list controlled pilot study.
Setting
Nonprofit academic medical center and university medical center with associated community
practice affiliates.
Participants
Adult female survivors of stage I-III breast cancer reporting cognitive complaints
2 months to 5 years after chemotherapy (N=61). Ongoing endocrine and/or anti-HER-2
therapy was allowed. Patients were excluded for history of other conditions involving
impaired cognitive function. Combination referred and volunteered sample. In total,
107 women were screened, 61 consented, and 52 analyzed. No attrition due to adverse
events. Group allocation was based on consent timing and next scheduled cohort to
minimize wait time for wait-list controls.
Intervention
Psychoeducation-based cognitive rehabilitation intervention delivered in a group setting
during 6 weekly 2.5-hour classes. Included presentation, class exercises, discussion,
and homework exercises. Provided in-person and virtually by Health Insurance Portability
and Accountability Act compliant and encrypted telehealth conferencing.
Main Outcome Measures
Primary: self-report of perceived cognitive function (PCF) was compared between the
intervention group (n=27) and wait-list controls (n=28) with the Functional Assessment
of Cancer Therapy-Cognition perceived cognitive impairment subscale. Secondary: feasibility
for multisite delivery via teleconferencing was measured by total accrual, percent
adherence to 4 of the 6 weeks of content, and participant satisfaction ratings.
Results
The intervention group demonstrated improvement in PCF both at the conclusion of the
intervention and 1 month later (P<.01). Within-group improvement in PCF was maintained at 6 and 12 months (P<.01).
Conclusion
These study results provide further preliminary evidence of the efficacy of psychoeducation-based
cognitive rehabilitation as an intervention for decreased PCF in breast cancer survivors
with cognitive complaints after chemotherapy. Feasibility for accrual, adherence,
and participant satisfaction with secure telehealth conferencing was demonstrated.
These positive pilot study results will inform future work.
Keywords
List of abbreviations:
BCS (breast cancer survivor), CRCI (cancer-related cognitive impairment), FACT-Cog (Functional Assessment of Cancer Therapy-Cognition), KUMC (University of Kansas Medical Center), PCA (perceived cognitive abilities), PCF (perceived cognitive function), PCI (perceived cognitive impairment), PROMIS (Patient-Reported Outcomes Measurement Information System), QOL (quality of life), UCLA (University of California Los Angeles)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 13, 2020
Footnotes
Supported in part by the Tower Cancer Research Foundation (grant no. CSR209500 to A.A. and M.-Y.J.) and the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center.
Disclosures: none.
Clinical Trial Registration No.: NCT02360917.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
