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Kubo A, Kurtovich E, McGinnis M, Aghaee S, Altschuler A, Quesenberry C, Kolevska T, Liu R, Greyz-Yusupov N, Avins A. Pilot pragmatic randomized trial of mHealth mindfulness-based intervention for advanced cancer patients and their informal caregivers. Psychooncology 2024; 33:e5557. [PMID: 32979294 DOI: 10.1002/pon.5557] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Assess the feasibility of conducting a cluster randomized controlled trial (RCT) comparing technology-delivered mindfulness-based intervention (MBI) programs against a waitlist control arm targeting advanced cancer patients and their informal caregivers. METHODS Two-arm cluster RCT within Kaiser Permanente Northern California. We recruited patients with metastatic solid malignancies or hematological cancers and their informal caregivers. Intervention-group participants chose to use either a commercially available mindfulness app (10-20 min/day) or a webinar-based mindfulness course for 6 weeks. The waitlist control group received usual care. We assessed feasibility measures and obtained participant-reported data on quality of life (QoL; primary outcome) and distress outcomes (secondary) pre- and postintervention. RESULTS A hundred and three patients (median age 67 years; 70% female; 81% White) and 39 caregivers (median age 66 years; 79% female; 69% White) were enrolled. Nearly all participants chose the mindfulness app over the webinar-based program. Among the participants in the intervention arm who chose the mobile-app program and completed the postintervention (6-week) survey, 21 (68%) patients and 7 (47%) caregivers practiced mindfulness at least 50% of the days during the 6-week study period. Seventy-four percent of intervention participants were "very" or "extremely" satisfied with the mindfulness program. We observed improvements in anxiety, QoL, and mindfulness among patients in the intervention arm compared to those in the control group. CONCLUSIONS We demonstrated the feasibility of conducting a cluster RCT of mHealth MBI for advanced cancer patients and their caregivers. Such remote interventions can be helpful particularly during the COVID-19 pandemic.
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Affiliation(s)
- Ai Kubo
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Elaine Kurtovich
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - MegAnn McGinnis
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Sara Aghaee
- Kaiser Permanente Division of Research, Oakland, California, USA
| | | | | | - Tatjana Kolevska
- Kaiser Permanente Napa/Solano Medical Center, Vallejo, California, USA
| | - Raymond Liu
- Kaiser Permanente Division of Research, Oakland, California, USA
- Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
| | | | - Andrew Avins
- Kaiser Permanente Division of Research, Oakland, California, USA
- School of Medicine, University of California, San Francisco, California, USA
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Barton DL, Pugh SL, Ganz PA, Plaxe SC, Koontz BF, Carter J, Greyz-Yusupov N, Page SJ, Rowland KM, Balcueva EP, Nabeel S, Basil JB, Hill ML, Muller CY, Bell MC, Deshmukh S, Kachnic LA. Randomized Controlled Phase II Evaluation of Two Dose Levels of Bupropion Versus Placebo for Sexual Desire in Female Cancer Survivors: NRG-CC004. J Clin Oncol 2022; 40:324-334. [PMID: 34882500 PMCID: PMC8797544 DOI: 10.1200/jco.21.01473] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Because of the negative impact of cancer treatment on female sexual function, effective treatments are warranted. The purpose of this multisite study was to evaluate the ability of two dose levels of extended-release bupropion, a dopaminergic agent, to improve sexual desire more than placebo at 9 weeks, measured by the desire subscale of the Female Sexual Function Index (FSFI), and to evaluate associated toxicities. METHODS Postmenopausal women diagnosed with breast or gynecologic cancer and low baseline FSFI desire scores (< 3.3), who had completed definitive cancer therapy, were eligible. Women were randomly assigned to receive 150 mg or 300 mg once daily of extended-release bupropion or a matching placebo. t-tests were performed on the FSFI desire subscale to evaluate whether there was a significantly greater change from baseline to 9 weeks between placebo and each bupropion arm as the primary end point. Sixty-two patients per arm provided 80% power using a one-sided t-test. RESULTS Two hundred thirty women were randomly assigned from 72 institutions through the NRG Oncology NCORP network. At 9 weeks, there were no statistically significant differences in change of the desire subscale scores between groups; participants in all three arms reported improvement. The mean changes for each arm were placebo 0.62 (standard deviation [SD] = 1.18), 150-mg once daily bupropion 0.64 (SD = 0.95), and 300-mg once daily bupropion 0.60 (SD = 0.89). Total and subscale scores on the FSFI were low throughout the study, indicating dysfunction in all groups. CONCLUSION Bupropion was not more effective than placebo in improving the desire subscale of the FSFI. Subscale and total scores of the FSFI demonstrated dysfunction throughout the 9 weeks of the study. More research is needed to support sexual function in female cancer survivors.
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Affiliation(s)
- Debra L. Barton
- University of Michigan School of Nursing, Ann Arbor, MI,Debra L. Barton, RN, PhD, University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI 48109-5482; e-mail:
| | - Stephanie L. Pugh
- NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, PA
| | | | | | | | - Jeanne Carter
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | - Ernie P. Balcueva
- Ascension Michigan St Marys Hospital, Saginaw, MI accrual under Michigan Cancer Research Consortium NCORP
| | - Sobia Nabeel
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Jack B. Basil
- Bethesda North Hospital, Cincinnati, OH accrual under Catholic Health Initiatives NCORP
| | - Matthew L. Hill
- Medical Oncology and Hematology Associates-Des Moines, Des Moines, IA accrual under Iowa-Wide Oncology Research Coalition NCORP
| | - Carolyn Y. Muller
- University of New Mexico Cancer Center, Albuquerque, NM accrual under New Mexico Minority Underserved NCORP
| | - Maria C. Bell
- Sanford Health, Sioux Falls, SD accrual under Sanford NCI Community Oncology Research Program of the North Central Plains
| | - Snehal Deshmukh
- NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, PA
| | - Lisa A. Kachnic
- NYP-Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center, New York, NY
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