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Gates P, Green HJ, Gough K, Dhillon H, Vardy JL, Dickinson M, Guarnera J, Krishnasamy M, Livingston PM, White V, Ugalde A, Caeyenberghs K. Web-based cognitive rehabilitation intervention for cancer-related cognitive impairment following chemotherapy for aggressive lymphoma: protocol for a randomised pilot trial. BMJ Open 2024; 14:e081084. [PMID: 38653511 PMCID: PMC11043699 DOI: 10.1136/bmjopen-2023-081084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION Cancer-related cognitive impairment is common among people diagnosed with and treated for cancer. This can be a distressing and disabling side effect for impacted individuals. Interventions to mitigate cognitive dysfunction are available, but, to date, most have been trialled in samples that are largely or exclusively composed of people with solid tumours. Intervention strategies to support cognitive functioning are needed, but there is a paucity of research in this area. The main aim of this study is to test the feasibility and acceptability of methods and procedures intended for use in a definitive trial of a web-based cognitive rehabilitation programme, Responding to Cognitive Concerns (eReCog), in people who have received chemotherapy for aggressive lymphoma. METHODS AND ANALYSIS The proposed study is a single-site, parallel-group, pilot randomised controlled trial, with one baseline and one follow-up (or postintervention) assessment. 38 people from the target population with low perceived cognitive function based on the Cognitive Change Screen will be recruited from a specialist cancer centre between July 2023 and June 2024. After baseline assessment, participants will be randomised one-to-one to receive usual care only (a factsheet about changes in memory and thinking for people with cancer) or eReCog plus usual care. The 4-week eReCog intervention consists of four online modules offering psychoeducation on cognitive impairment associated with cancer and its treatment, skills training for improving memory, and attention and relaxation training. Study outcomes will include the feasibility of recruitment and retention at follow-up assessment (primary outcomes), as well as adherence to, usability of and intrinsic motivation to engage with eReCog, and compliance with study measures. The potential efficacy of eReCog will also be evaluated. ETHICS AND DISSEMINATION Ethical approval was granted by the Peter MacCallum Cancer Centre Human Research Ethics Committee in Victoria, Australia (HREC/97384/PMCC). Study findings will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry, ACTRN12623000705684.
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Affiliation(s)
- Priscilla Gates
- Cognitive Neuroscience Unit, Deakin University, Burwood, Victoria, Australia
- Health Services Research, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
| | - Heather J Green
- Faculty of Health, Griffith University, Gold Coast, Queensland, Australia
| | - Karla Gough
- Health Services Research, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Haryana Dhillon
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Janette L Vardy
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Concord Cancer Centre, Concord, New South Wales, Australia
| | - Michael Dickinson
- Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jade Guarnera
- Cognitive Neuroscience Unit, Deakin University, Burwood, Victoria, Australia
| | - Meinir Krishnasamy
- Health Services Research, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Victoria White
- Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Anna Ugalde
- Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, Deakin University, Burwood, Victoria, Australia
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Gates P, Krishnasamy M, Wilson C, Hawkes EA, Doré V, Perchyonok Y, Rowe CC, Walker AK, Vardy JL, de Ruiter MB, Cushion T, Dhillon HM, Gough K. Cancer-related cognitive impairment in patients with newly diagnosed aggressive lymphoma undergoing standard chemotherapy: a longitudinal feasibility study. Support Care Cancer 2022; 30:7731-7743. [PMID: 35699780 PMCID: PMC9385796 DOI: 10.1007/s00520-022-07153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) is a recognised adverse consequence of cancer and its treatment. This study assessed the feasibility of collecting longitudinal data on cognition in patients with newly diagnosed, aggressive lymphoma undergoing standard therapy with curative intent via self-report, neuropsychological assessment, peripheral markers of inflammation, and neuroimaging. An exploration and description of patterns of cancer-related cognitive impairment over the course of treatment and recovery was also undertaken and will be reported separately. METHODS Eligible participants completed repeated measures of cognition including self-report and neuropsychological assessment, and correlates of cognition including blood cell-based inflammatory markers, and neuroimaging at three pre-specified timepoints, time 1 (T1) - pre-treatment (treatment naïve), time 2 (T2) - mid-treatment, and time 3 (T3) - 6 to 8 weeks post-completion of treatment. RESULTS 30/33 eligible patients (91%, 95% CI: 76%, 97%) were recruited over 10 months. The recruitment rate was 3 patients/month (95% CI: 2.0, 4.3 patients/month). Reasons for declining included feeling overwhelmed and rapid treatment commencement. Mean age was 57 years (SD = 17 years) and 16/30 (53%) were male. Most patients (20/30, 67%) had diffuse large B cell lymphoma or Hodgkin lymphoma (4/30, 13%). The neuroimaging sub-study was optional, 11/30 participants (37%) were eligible to take part, and all agreed. The remaining 19 participants were ineligible as their diagnostic PET/CT scan was completed prior. Retention and compliance with all assessments were 89 to 100% at all timepoints. Only one participant was withdrawn due to disease progression. CONCLUSIONS Findings from this study including excellent recruitment, retention, and compliance rates demonstrate it is feasible to longitudinally assess cognition in people with newly diagnosed aggressive lymphoma during their initial treatment and recovery to inform the development of future research to improve patient experiences and cognitive outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619001649101.
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Affiliation(s)
- Priscilla Gates
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia.
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Meinir Krishnasamy
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Research and Education Nursing, Victorian Comprehensive Cancer Centre Alliance, Melbourne, Victoria, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
- School of Psychology and Public Health, LaTrobe University, Melbourne, Victoria, Australia
| | - Eliza A Hawkes
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute (ONJCRI), Austin Health, Melbourne, Victoria, Australia
| | - Vincent Doré
- Department Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
- The Australian E-Health Research Centre, CSIRO Health & Biosecurity, Melbourne, Victoria, Australia
| | - Yuliya Perchyonok
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Adam K Walker
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Janette L Vardy
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Concord Cancer Centre, Concord Repatriation and General Hospital, Concord, New South Wales, Australia
| | | | - Tania Cushion
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia
| | - Haryana M Dhillon
- Faculty of Science, School of Psychology, Centre for Medical Psychology& Evidence-Based Decision-Making, The University of Sydney, Sydney, New South Wales, Australia
| | - Karla Gough
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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