Samantha J Mayo1,2, Sean B Rourke3,4, Eshetu G Atenafu5, Rita Vitorino6, Christine Chen7,8, John Kuruvilla7,8. 1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St., Suite 130, Toronto, ON, M5T 1P8, Canada. samantha.mayo@utoronto.ca. 2. Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. samantha.mayo@utoronto.ca. 3. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. 4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 5. Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. 6. Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 7. Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. 8. Department of Medicine, University of Toronto, Toronto, ON, Canada.
Abstract
BACKGROUND: Computerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors. For patients presenting with cognitive symptoms in the early post-treatment phase, the benefit of CCT is unclear. To assess the possibility of testing the effectiveness of CCT in the early post-treatment period, our aim was to investigate the feasibility of an 8-week home-based, online CCT intervention among patients who have recently completed treatment for hematological malignancy. METHODS: This study was a single-arm, non-blinded, feasibility study. All participants were provided with the CCT intervention for an 8-week period. Feasibility was evaluated based on participant adherence and patient perceptions of the intervention, assessed through responses to an acceptability questionnaire and semi-structured interviews at the end of the intervention period. RESULTS: The feasibility study included 19 patients who had completed treatment for hematological malignancy at a Canadian tertiary cancer center. Adherence to the CCT intervention was limited, with only one participant meeting the criteria for intervention adherence. At the end of the intervention period, participants characterized the program as easy to follow (92%) and felt well-prepared for how to complete the exercises (100%). In semi-structured interviews, participants highlighted post-treatment barriers to intervention adherence that included symptom burden and competing time demands. Participants also suggested improvements to the intervention that could help maintain adherence despite these barriers, such as fostering a sense of accountability, providing personalized feedback and coaching, and enabling opportunities for peer support. CONCLUSIONS: Participation in CCT can be challenging in the post-treatment period for hematological cancers. Further research on the effectiveness of CCT in this setting may require the implementation of strategies that support participants' engagement with the intervention in the context of symptoms and competing demands, such as establishing a minimum dose requirement and integrating approaches to help promote and sustain motivation.
BACKGROUND: Computerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors. For patients presenting with cognitive symptoms in the early post-treatment phase, the benefit of CCT is unclear. To assess the possibility of testing the effectiveness of CCT in the early post-treatment period, our aim was to investigate the feasibility of an 8-week home-based, online CCT intervention among patients who have recently completed treatment for hematological malignancy. METHODS: This study was a single-arm, non-blinded, feasibility study. All participants were provided with the CCT intervention for an 8-week period. Feasibility was evaluated based on participant adherence and patient perceptions of the intervention, assessed through responses to an acceptability questionnaire and semi-structured interviews at the end of the intervention period. RESULTS: The feasibility study included 19 patients who had completed treatment for hematological malignancy at a Canadian tertiary cancer center. Adherence to the CCT intervention was limited, with only one participant meeting the criteria for intervention adherence. At the end of the intervention period, participants characterized the program as easy to follow (92%) and felt well-prepared for how to complete the exercises (100%). In semi-structured interviews, participants highlighted post-treatment barriers to intervention adherence that included symptom burden and competing time demands. Participants also suggested improvements to the intervention that could help maintain adherence despite these barriers, such as fostering a sense of accountability, providing personalized feedback and coaching, and enabling opportunities for peer support. CONCLUSIONS: Participation in CCT can be challenging in the post-treatment period for hematological cancers. Further research on the effectiveness of CCT in this setting may require the implementation of strategies that support participants' engagement with the intervention in the context of symptoms and competing demands, such as establishing a minimum dose requirement and integrating approaches to help promote and sustain motivation.
Authors: S Mayo; H A Messner; S B Rourke; D Howell; J C Victor; J Kuruvilla; J H Lipton; V Gupta; D D Kim; C Piescic; D Breen; A Lambie; D Loach; F V Michelis; N Alam; J Uhm; L McGillis; K Metcalfe Journal: Bone Marrow Transplant Date: 2016-02-29 Impact factor: 5.483
Authors: Robert K Heaton; Thomas D Marcotte; Monica Rivera Mindt; Joseph Sadek; David J Moore; Heather Bentley; J Allen McCutchan; Carla Reicks; Igor Grant Journal: J Int Neuropsychol Soc Date: 2004-05 Impact factor: 2.892
Authors: Helena Harder; Jan J Cornelissen; Arthur R Van Gool; Hugo J Duivenvoorden; Wil M H Eijkenboom; Martin J van den Bent Journal: Cancer Date: 2002-07-01 Impact factor: 6.860
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