Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Telehealth cognitive behaviour therapy for the management of sleep disturbance in women with early breast cancer receiving chemotherapy: a feasibility study (#251)

Emma-Kate Carson 1 2 3 , Janette L Vardy 3 4 5 , Haryana M Dhillon 5 6 , Christopher Brown 7 , Kelly N Nunes-Zlotkowski 5 6 , Stephen Della-Fiorentina 2 8 9 , Sarah Khan 9 , Andrew Parsonson 10 11 , Felicia Roncolato 1 2 3 , Antonia Pearson 3 12 , Tristan Barnes 3 12 , Belinda E Kiely 1 2 3 7
  1. Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia
  2. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  3. Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
  4. Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
  5. Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  6. Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
  7. NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
  8. Cancer Services, South Western Sydney Local Health District, Liverpool, NSW, Australia
  9. Southern Highlands Cancer Centre, Southern Highlands Private Hospital, Bowral, NSW, Australia
  10. Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
  11. Nepean Cancer Care Centre, Nepean Hospital , Kingswood, NSW, Australia
  12. Northern Beaches Cancer Care , Northern Beaches Hospital , Frenchs Forest, NSW, Australia

Aim

Sleep quality commonly deteriorates in women receiving chemotherapy for early breast cancer (BC). We sought to determine the feasibility and acceptability of telehealth delivered cognitive behaviour therapy for insomnia (CBT-I) in women with early BC receiving (neo)adjuvant chemotherapy.

 

Methods

In this multi-centre, single arm, phase 2 feasibility trial, women with stage I to III BC received 4 sessions of telehealth CBT-I over 8 weeks, during (neo)adjuvant chemotherapy. CBT-I was delivered by psychologists and started before cycle 2 chemotherapy. Participants completed Pittsburgh Sleep Quality Index (PSQI) and other patient reported outcome measures (PROM) (FACT-B, FACT-F, HADS, Distress Thermometer) at baseline, post-program (week 9) and post-chemotherapy (week 24); and an Acceptability Questionnaire at week 9. Bedtime, awake-time, use of steroids and rescue sleep medications were recorded. Primary endpoint was proportion of women completing 4 sessions of telehealth CBT-I.

 

Results

41 participants were recruited: mean age 51 years (range 31-73). All 4 CBT-I sessions were completed by 35 (85%) participants. Of 31 participants completing the post-program questionnaire, 74% reported ‘the program was useful’, 83% ‘would recommend the program to others’ and 66% believed ‘the program was generally effective’. There was no significant difference in the number of poor sleepers (PSQI score ≥5) at baseline 29/40 (73%) and week 24 17/25 (68%); or in the mean PSQI score at baseline (7.43, SD 4.06) and week 24 (7.48, SD 4.41). From baseline to week 24, 7/25 (28%) participants had a ≥3 point improvement in sleep quality on PSQI, and 5/25 (20%) had a ≥3 point deterioration. There was no significant difference in mean PROM scores.

 

Conclusion

It is feasible to deliver telehealth CBT-I to women with early BC receiving chemotherapy. Sleep quality did not deteriorate, as predicted from the literature, and for most, sleep quality was unchanged. Telehealth CBT-I has a potential role in preventing and managing sleep disturbance during chemotherapy.