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CompletedNCT03285633Updated Aug 19, 2019

Telephone-Based Mindfulness CBT for Patients in Community Settings With Advanced Cancer

An interventional study of Cognitive Behavioral Mutli-Symptom management(CBT) in Advanced Cancer, sponsored by Duke University. Completed at 1 site in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2019-08-19.

Sponsored by Duke University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Not applicable
Ages
21 Years and older
Sex
All
01

Study summary

This study examines the feasibility and acceptability of an open trial of mindfulness-based Cognitive Behavioral Therapy intervention delivered via telephone to men and women age 21 and older with a diagnosis of advanced cancer. Potential participants (N=35) will be recruited via letter from their oncologist at community-based clinics (N=18) and those served at the Duke Cancer Institute in Durham who live more than 60 miles away (N=17). Following informed consent, participants will be asked to complete assessments (e..g., examining their pain, anxiety, depression, fatigue, and engagement in valued activity). They will then receive 4 weekly 50-minute telephone sessions with a study therapist and practice skills learned in session at home. After completing the 4 sessions, they will complete a post-treatment assessment. Data analyses will examine the feasibility and acceptability of the study by assessing participant engagement, and will examine changes in key psychological variables (e.g., pain, anxiety, depression, fatigue, and valued activity) from baseline to post-treatment.

Read the detailed description

Individuals with advanced cancers often experience significant symptom burden including pain, fatigue, and psychological distress, all while facing acceptance of the meaning of their advanced disease. Evidence-based behavioral interventions have been developed to alleviate this multiple symptom burden but are understudied and the treatments that are available are often not easily accessed by patients most in need in community-based settings. The current study examines the feasibility and acceptability of an open trial of mindfulness-based Cognitive Behavioral Therapy intervention delivered via telephone to men and women age 21 and older with a diagnosis of advanced cancer. Potential participants (N=35) will be recruited via letter from their oncologist at community-based clinics (N=18) and those served at the Duke Cancer Institute in Durham who live more than 60 miles away (N=17). Following informed consent, participants will be asked to complete assessments (e..g., examining their pain, anxiety, depression, fatigue, and engagement in valued activity). They will then receive 4 weekly 50-minute telephone sessions with a study therapist and practice skills learned in session at home. After completing the 4 sessions, they will complete a post-treatment assessment. Data analyses will examine the feasibility and acceptability of the study by assessing participant engagement, and will examine changes in key psychological variables (e.g., pain, anxiety, depression, fatigue, and valued activity) from baseline to post-treatment. There is minimal risk related to confidentiality of data and the possibility of feeling uncomfortable in the study. All study contacts will be conducted by trained study staff and supervised by the PI; a licensed clinical psychologist. Participant tracking data will be stored online via REDCAP and accessed only by study staff, participant assessment data will be collected and stored online via REDCap, and audio recordings of study telephone sessions will be stored on Duke servers.

02

Conditions studied

  • Advanced Cancer

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03

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • being at least 21 years of age
  • a diagnosis of stage IV cancer in the past 3 years
  • being able to speak/read English

Exclusion criteria

Exclusion Criteria:

  • visual or hearing impairment that would prevent ability to engage in the telephone session or study materials
  • presence of a severe unmanaged psychiatric condition (i.e., psychotic disorder or episode) or a psychiatric condition (e.g., suicidal intent) that would contraindicate safe participation in the study as indicated by the medical chart, treating oncologist, or interactions with the medical/study staff.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
24 participants (actual)

Study arms

  • Other
    Cognitive Behavioral Mutli-Symptom management(CBT)

    Learn to manage distress, fatigue, and/or pain via Cognitive Behavioral Multi-Symptom Management(CBT). Four sessions will be conducted each session is approximately one hour.

    Behavioral: Cognitive Behavioral Mutli-Symptom management(CBT)

Interventions

  • BehavioralCognitive Behavioral Mutli-Symptom management(CBT)

    Learn to manage distress, fatigue, and/or pain via (Cognitive Behavioral Multi-Symptom management (CBT) four one hour sessions.

05

What researchers measure

Primary outcomes

  1. Feasibility as measured by study attrition which will be assessed by patients who do not complete the post-assessment.

    Feasibility will be shown by no more than 20% study attrition.

    Time frame: 8 weeks

  2. Acceptability, as measured by Client Satisfaction Questionnaire 10-item version

    Acceptability will be indicated by at least 80% of the participants reporting satisfaction with the CBT protocol (mean score of 7) on the CSQ

    Time frame: 8 weeks

  3. Feasibility as measured by study accrual by meeting recruitment goal

    Feasibility will be shown by meeting targeted study accrual (N=35) in the 12-month study period.

    Time frame: 8 weeks

  4. Feasibility as measured by adherence to the study protocol by number of intervention sessions completed by the participant

    Feasibility will be shown by adherence to at least 75% of the intervention sessions (3/4)

    Time frame: 8 weeks

Secondary outcomes

  1. Change in pain

    Pain will be assessed with the Brief Pain Inventory (BPI)

    Time frame: Baseline and 8 weeks

  2. Change in fatigue

    Fatigue will be assessed with the PROMIS Adult Fatigue Profile Short Form.

    Time frame: Baseline and 8 weeks

  3. Change in depression

    The Hospital Anxiety and Depression Scale will be used to assess distress (anxiety and depressive symptoms)

    Time frame: Baseline and 8 weeks

  4. Change in Mindfulness

    Acceptance and mindfulness will be assessed using the Acceptance and Action Questionnaire-II, the most widely used measure of mechanism of change in ACT-based medical treatment studies.

    Time frame: Baseline and 8 weeks

  5. Change in anxiety

    The Hospital Anxiety and Depression Scale will be used to assess distress (anxiety and depressive symptoms)

    Time frame: Baseline and 8 weeks

  6. Change in Acceptance

    Acceptance and mindfulness will be assessed using the Acceptance and Action Questionnaire-II, the most widely used measure of mechanism of change in ACT-based medical treatment studies.

    Time frame: Baseline and 8 weeks

06

Study locations

1 site
  • Duke University Medical Center
    Durham, North Carolina 27705, United States
07

Registry details

Key details

Study ID
NCT03285633
Lead sponsor
Duke University
Collaborators
Palliative Care Research Cooperative Group
Responsible party
Sponsor
First posted
Sep 18, 2017
Start date
Jan 3, 2018
Primary completion
Sep 8, 2018
Completion
Sep 8, 2018
Last update
Aug 19, 2019

Study contacts

Jennifer Plumb Vilardaga
principal investigator · Duke University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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