Oxana Palesh1, Caroline Scheiber2, Shelli Kesler3, Michelle C Janelsins4, Joseph J Guido4, Charles Heckler4, Mallory G Cases2, Jessica Miller5, Nick G Chrysson6, Karen M Mustian4. 1. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA. opalesh@stanford.edu. 2. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA. 3. University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY, USA. 5. Metro-Minnesota Community Oncology Research Consortium, Minneapolis, MN, USA. 6. Novant Health Oncology Specialists, Winston-Salem, NC, USA.
Abstract
BACKGROUND: This phase II RCT was conducted to determine the feasibility and acceptability of brief behavioral therapy for cancer-related insomnia (BBT-CI) in breast cancer patients undergoing chemotherapy. We also assessed the preliminary effects of BBT-CI on insomnia and circadian rhythm in comparison to a Healthy Eating Education Learning control condition (HEAL). METHODS: Of the 71 participants recruited, 34 were randomised to receive BBT-CI and 37 to receive HEAL. Oncology staff was trained to deliver the intervention in four community clinics affiliated with the NCI. Insomnia was assessed with the Insomnia Severity Index (ISI), and circadian rhythm was assessed using a wrist-worn actiwatch. RESULTS: Community staff interveners delivered 72% of the intervention components, with a recruitment rate of 77% and an adherence rate of 73%, meeting acceptability and feasibility benchmarks. Those randomised to BBT-CI improved their ISI scores by 6.3 points compared to a 2.5-point improvement in those randomised to HEAL (P = 0.041). Actigraphy data indicated that circadian functioning improved in the BBT-CI arm as compared to the HEAL arm at post-intervention (all P-values <0.05). CONCLUSIONS: BBT-CI is an acceptable and feasible intervention that can be delivered directly in the community oncology setting by trained staff. The BBT-CI arm experienced significant improvements in insomnia and circadian rhythm as compared to the control condition.
BACKGROUND: This phase II RCT was conducted to determine the feasibility and acceptability of brief behavioral therapy for cancer-related insomnia (BBT-CI) in breast cancer patients undergoing chemotherapy. We also assessed the preliminary effects of BBT-CI on insomnia and circadian rhythm in comparison to a Healthy Eating Education Learning control condition (HEAL). METHODS: Of the 71 participants recruited, 34 were randomised to receive BBT-CI and 37 to receive HEAL. Oncology staff was trained to deliver the intervention in four community clinics affiliated with the NCI. Insomnia was assessed with the Insomnia Severity Index (ISI), and circadian rhythm was assessed using a wrist-worn actiwatch. RESULTS: Community staff interveners delivered 72% of the intervention components, with a recruitment rate of 77% and an adherence rate of 73%, meeting acceptability and feasibility benchmarks. Those randomised to BBT-CI improved their ISI scores by 6.3 points compared to a 2.5-point improvement in those randomised to HEAL (P = 0.041). Actigraphy data indicated that circadian functioning improved in the BBT-CI arm as compared to the HEAL arm at post-intervention (all P-values <0.05). CONCLUSIONS: BBT-CI is an acceptable and feasible intervention that can be delivered directly in the community oncology setting by trained staff. The BBT-CI arm experienced significant improvements in insomnia and circadian rhythm as compared to the control condition.
Authors: Oxana Palesh; Caroline Scheiber; Shelli Kesler; Richard Gevirtz; Charles Heckler; Joseph J Guido; Michelle Janelsins; Mallory G Cases; Bingjie Tong; Jessica M Miller; Nick G Chrysson; Karen Mustian Journal: Health Psychol Date: 2019-03 Impact factor: 4.267
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