Trial Outcomes & Findings for Telephone Support for Metastatic Breast Cancer Patients (NCT NCT03998618)

NCT ID: NCT03998618

Last Updated: 2024-10-10

Results Overview

Seven items are rated on 11-point scales (0=no interference to 10=extreme interference) that assess the extent to which fatigue in the past week interfered with general level of activity, ability to bathe and dress, normal work activity (including housework), ability to concentrate, relations with others, enjoyment of life, and mood. The seven items are summed with higher total scores indicating greater fatigue interference. The total score range is 0 to 70. This is the primary outcome.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

250 participants

Primary outcome timeframe

2 weeks, 3 months, and 6 months post-intervention

Results posted on

2024-10-10

Participant Flow

14 patients were excluded from the study before assignment to groups. Here is a list of the reasons: Not feeling well/health problems (2), Did not have time (5), Participation was too much work (4), Not interested in the study (1), Not eligible (1), Other (1)

Participant milestones

Participant milestones
Measure
Acceptance and Commitment Therapy
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Overall Study
STARTED
116
120
Overall Study
COMPLETED
97
91
Overall Study
NOT COMPLETED
19
29

Reasons for withdrawal

Reasons for withdrawal
Measure
Acceptance and Commitment Therapy
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Overall Study
Death
7
11
Overall Study
hospice enrollment
3
3
Overall Study
Not feeling well/health problems
3
5
Overall Study
Lost to Follow-up
6
6
Overall Study
Withdrawal by Subject
0
4

Baseline Characteristics

Telephone Support for Metastatic Breast Cancer Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Acceptance and Commitment Therapy
n=116 Participants
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 Participants
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Total
n=236 Participants
Total of all reporting groups
Age, Continuous
58.4 years
STANDARD_DEVIATION 11.4 • n=5 Participants
59.6 years
STANDARD_DEVIATION 11.7 • n=7 Participants
58.97 years
STANDARD_DEVIATION 11.54 • n=5 Participants
Sex: Female, Male
Female
116 Participants
n=5 Participants
120 Participants
n=7 Participants
236 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
115 Participants
n=5 Participants
118 Participants
n=7 Participants
233 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
8 Participants
n=5 Participants
16 Participants
n=7 Participants
24 Participants
n=5 Participants
Race (NIH/OMB)
White
107 Participants
n=5 Participants
103 Participants
n=7 Participants
210 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
116 Participants
n=5 Participants
120 Participants
n=7 Participants
236 Participants
n=5 Participants
Household income
$0 to $50,999
45 Participants
n=5 Participants
46 Participants
n=7 Participants
91 Participants
n=5 Participants
Household income
$51,000 to $99,999
29 Participants
n=5 Participants
35 Participants
n=7 Participants
64 Participants
n=5 Participants
Household income
$100,000 or more
33 Participants
n=5 Participants
33 Participants
n=7 Participants
66 Participants
n=5 Participants
Household income
Missing data
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
Years of education
15.3 years
STANDARD_DEVIATION 2.38 • n=5 Participants
15.2 years
STANDARD_DEVIATION 2.73 • n=7 Participants
15.27 years
STANDARD_DEVIATION 2.56 • n=5 Participants
Time since stage IV breast cancer diagnosis
2.75 years
STANDARD_DEVIATION 3.62 • n=5 Participants
2.94 years
STANDARD_DEVIATION 3.72 • n=7 Participants
2.85 years
STANDARD_DEVIATION 3.67 • n=5 Participants
Chemotherapy
Yes-chemotherapy received for breast cancer
85 Participants
n=5 Participants
100 Participants
n=7 Participants
185 Participants
n=5 Participants
Chemotherapy
No-chemotherapy not received for breast cancer
31 Participants
n=5 Participants
20 Participants
n=7 Participants
51 Participants
n=5 Participants
Radiation
Yes-radiation received for breast cancer
93 Participants
n=5 Participants
90 Participants
n=7 Participants
183 Participants
n=5 Participants
Radiation
No-radiation not received for breast cancer
23 Participants
n=5 Participants
30 Participants
n=7 Participants
53 Participants
n=5 Participants
Hormonal Therapy
Yes-hormonal therapy received for breast cancer
90 Participants
n=5 Participants
98 Participants
n=7 Participants
188 Participants
n=5 Participants
Hormonal Therapy
No-hormonal therapy not received for breast cancer
26 Participants
n=5 Participants
22 Participants
n=7 Participants
48 Participants
n=5 Participants
Targeted Therapy
Yes-targeted therapy received for breast cancer
37 Participants
n=5 Participants
36 Participants
n=7 Participants
73 Participants
n=5 Participants
Targeted Therapy
No-targeted therapy not received for breast cancer
79 Participants
n=5 Participants
84 Participants
n=7 Participants
163 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 weeks, 3 months, and 6 months post-intervention

Seven items are rated on 11-point scales (0=no interference to 10=extreme interference) that assess the extent to which fatigue in the past week interfered with general level of activity, ability to bathe and dress, normal work activity (including housework), ability to concentrate, relations with others, enjoyment of life, and mood. The seven items are summed with higher total scores indicating greater fatigue interference. The total score range is 0 to 70. This is the primary outcome.

Outcome measures

Outcome measures
Measure
Acceptance and Commitment Therapy
n=116 Participants
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 Participants
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Fatigue Interference Subscale of Fatigue Symptom Inventory
Fatigue interference at 2 weeks post-intervention
2.96 units on a scale
Standard Deviation 1.90
3.66 units on a scale
Standard Deviation 2.20
Fatigue Interference Subscale of Fatigue Symptom Inventory
Fatigue interference at 3 months post-intervention
3.24 units on a scale
Standard Deviation 2.05
3.43 units on a scale
Standard Deviation 2.25
Fatigue Interference Subscale of Fatigue Symptom Inventory
Fatigue interference at 6 months post-intervention
3.08 units on a scale
Standard Deviation 2.32
3.64 units on a scale
Standard Deviation 2.26

SECONDARY outcome

Timeframe: 2 weeks, 3 months, and 6 months post-intervention

This 8-item measure assesses the perceived interference of sleep problems with activities, mood, and cognition (e.g., difficulty concentrating or completing tasks). Each item is rated on a scale from 1 (not at all) to 5 (very much). Item #2 is reverse-scored and then the 8 items are summed with higher total scores indicating greater sleep-related impairment. The total scores are converted to T-scores with a range from 30.0 to 80.1. Higher T-scores indicate a worse outcome. The population mean for T-scores is 50 with a standard deviation of 10. This is a secondary outcome.

Outcome measures

Outcome measures
Measure
Acceptance and Commitment Therapy
n=116 Participants
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 Participants
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Patient Reported Outcomes Measurement Information System (PROMIS) Sleep-related Impairment
Sleep-related impairment at 2 weeks post-intervention
55.28 T-score
Standard Deviation 4.22
56.26 T-score
Standard Deviation 4.27
Patient Reported Outcomes Measurement Information System (PROMIS) Sleep-related Impairment
Sleep-related impairment at 3 months post-intervention
54.27 T-score
Standard Deviation 7.79
54.62 T-score
Standard Deviation 8.91
Patient Reported Outcomes Measurement Information System (PROMIS) Sleep-related Impairment
Sleep-related impairment at 6 months post-intervention
54.05 T-score
Standard Deviation 7.95
54.78 T-score
Standard Deviation 8.72

SECONDARY outcome

Timeframe: 2 weeks, 3 months, and 6 months post-intervention

This 6-item measure assesses participants' ability to participate in social roles and activities. The items measure difficulty engaging in social and recreational activities as well as usual work (including housework). Each item is rated on a scale from 1 (never) to 5 (always) and is reverse coded. Then the six items are summed with higher total scores indicating greater ability to participate in social roles and activities. The total scores are converted to T-scores with a range from 26.7 to 65.0 with higher scores indicating a better outcome. The population mean for T-scores is 50 with a standard deviation of 10. This is a secondary outcome.

Outcome measures

Outcome measures
Measure
Acceptance and Commitment Therapy
n=116 Participants
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 Participants
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
PROMIS Ability to Participate in Social Roles and Activities
Ability to participate in social roles and activities at 2 weeks post-intervention
46.75 T-score
Standard Deviation 6.79
46.66 T-score
Standard Deviation 6.86
PROMIS Ability to Participate in Social Roles and Activities
Ability to participate in social roles and activities at 3 months post-intervention
47.49 T-score
Standard Deviation 7.91
46.75 T-score
Standard Deviation 8.56
PROMIS Ability to Participate in Social Roles and Activities
Ability to participate in social roles and activities at 6 months post-intervention
46.81 T-score
Standard Deviation 8.17
46.10 T-score
Standard Deviation 8.01

SECONDARY outcome

Timeframe: 2 weeks, 3 months, and 6 months post-intervention

This 27-item measure evaluates physical, social/family, emotional, and functional quality of life. For each of the 4 subscale scores (i.e., Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being), the items are summed, multiplied by the number of items, and divided by the number of items answered, with higher scores indicating better quality of life. Items are rated on 0 to 4 scales. The physical well-being subscale is the sum of 7 items (all items reverse-coded) with a range of 0 to 28. The social/family well-being subscale is the sum of 7 items (none reverse-coded) with a range of 0 to 28. The emotional well-being subscale is the sum of 6 items (5 items reverse-coded) with a range of 0 to 24. The functional well-being subscale is the sum of 7 items (none reverse-coded) with a range of 0 to 28. This is a secondary outcome measure.

Outcome measures

Outcome measures
Measure
Acceptance and Commitment Therapy
n=116 Participants
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 Participants
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
Functional Assessment of Cancer Therapy-General
Physical quality of life at 2 weeks post-intervention
17.73 units on a scale
Standard Deviation 5.06
16.99 units on a scale
Standard Deviation 5.08
Functional Assessment of Cancer Therapy-General
Physical quality of life at 3 months post-intervention
17.34 units on a scale
Standard Deviation 5.80
16.90 units on a scale
Standard Deviation 6.07
Functional Assessment of Cancer Therapy-General
Physical quality of life at 6 months post-intervention
17.18 units on a scale
Standard Deviation 6.05
16.54 units on a scale
Standard Deviation 6.15
Functional Assessment of Cancer Therapy-General
Social/family quality of life at 2 weeks post-intervention
21.15 units on a scale
Standard Deviation 4.71
20.58 units on a scale
Standard Deviation 5.47
Functional Assessment of Cancer Therapy-General
Social/family quality of life at 3 months post-intervention
20.39 units on a scale
Standard Deviation 5.38
20.71 units on a scale
Standard Deviation 5.49
Functional Assessment of Cancer Therapy-General
Social/family quality of life at 6 months post-intervention
20.36 units on a scale
Standard Deviation 5.05
20.72 units on a scale
Standard Deviation 6.34
Functional Assessment of Cancer Therapy-General
Emotional quality of life at 2 weeks post-intervention
16.72 units on a scale
Standard Deviation 4.20
16.24 units on a scale
Standard Deviation 4.81
Functional Assessment of Cancer Therapy-General
Emotional quality of life at 3 months post-intervention
16.42 units on a scale
Standard Deviation 4.53
16.16 units on a scale
Standard Deviation 4.92
Functional Assessment of Cancer Therapy-General
Emotional quality of life at 6 months post-intervention
16.21 units on a scale
Standard Deviation 4.84
16.79 units on a scale
Standard Deviation 5.01
Functional Assessment of Cancer Therapy-General
Functional quality of life at 2 weeks post-intervention
17.84 units on a scale
Standard Deviation 4.53
16.99 units on a scale
Standard Deviation 5.39
Functional Assessment of Cancer Therapy-General
Functional quality of life at 3 months post-intervention
17.18 units on a scale
Standard Deviation 4.90
16.85 units on a scale
Standard Deviation 5.36
Functional Assessment of Cancer Therapy-General
Functional quality of life at 6 months post-intervention
17.47 units on a scale
Standard Deviation 5.43
16.68 units on a scale
Standard Deviation 5.28

Adverse Events

Acceptance and Commitment Therapy

Serious events: 7 serious events
Other events: 0 other events
Deaths: 7 deaths

Education/Support

Serious events: 11 serious events
Other events: 0 other events
Deaths: 11 deaths

Serious adverse events

Serious adverse events
Measure
Acceptance and Commitment Therapy
n=116 participants at risk
Patients in the ACT arm will learn new and more adaptive ways to respond to fatigue. Acceptance and Commitment Therapy: Across six weekly 50-minute sessions, patients in the Acceptance and Commitment Therapy condition will practice various mindfulness exercises, clarify their values, and set specific goals consistent with their values. Sessions will incorporate discussion of patients' cancer experiences. Through in-session and home practice of skills, participants will learn new and more adaptive ways to respond to fatigue. Participants will receive handouts on session topics and a compact disc (CD) that we developed to guide mindfulness practices.
Education/Support
n=120 participants at risk
Patients in the education/support arm will discuss their cancer-related concerns and receive education on services available in their medical center and community. Education/Support: Across six weekly 50-minute sessions, patients in the education/support condition will discuss their concerns, including symptoms and other cancer-related stressors, with a therapist providing psychological support. The therapist will direct patients to resources for practical and health information and contact information for psychosocial services. Sessions will include an orientation to the patient's medical center, education regarding common cancer-related symptoms and quality-of-life concerns, and an overview of resources for addressing these concerns. The therapist will also describe resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants will receive handouts on session topics and will be asked to review them as homework.
General disorders
Deaths
6.0%
7/116 • Number of events 7 • Adverse event data were collected on each participant from the point of baseline until approximately 8 months post-baseline.
9.2%
11/120 • Number of events 11 • Adverse event data were collected on each participant from the point of baseline until approximately 8 months post-baseline.

Other adverse events

Adverse event data not reported

Additional Information

Dr. Catherine Mosher

Indiana University

Phone: 317-274-6769

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place