Cognitively-Based Compassion Training to Improve Health-Related Quality of Life in Solid Tumor Cancer Survivors and Their Informal Caregivers: Findings from a Pilot Randomized Trial

Authors: Pace TWW, Dodds S, Sikorskii A, Badger TA, Segrin C, Negi LT, Harrison T, Crane TE

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020

Abstract Body:
PURPOSE OF THE STUDY: Cancer survivors and their informal caregivers (ICs)(i.e., family members or friends) often experience health-related quality of life (HRQOL) impairments after primary cancer treatment including psychological distress, fatigue, and feelings of social isolation. The goal of this pilot trial was to promote well-being in dyads consisting of solid tumor cancer survivors and ICs with an 8-week compassion meditation-based intervention called CBCT® (Cognitively-Based Compassion Training). We expected that CBCT would improve HRQOL in both solid tumor cancer survivors and ICs. METHODS: Dyads (N = 31) included solid tumor survivors within 10 years of completing primary treatments (chemotherapy, radiation, surgery) and ICs, with at least one dyad member with mild depression or anxiety symptoms (determined by Patient Reported Outcomes Measurement Information System [PROMIS] 4a short forms). Dyads were randomized 1:1 to either CBCT or an 8-week active attention control (cancer health education, CHE). We used PROMIS 8a forms to assess depression and anxiety, the Positive and Negative Affect Scale to assess positive and negative affect, and the Quality of Life Index (QLI) to assess HRQOL. General linear models related post-intervention outcomes to trial arm, and outcomes at baseline were used to estimate the adjusted effects sizes (ES) for the differences between trial arms. Effect sizes exceeding 0.33 are often deemed clinically significant. RESULTS: Among survivors (mean age 63, standard deviation 11, 87% female), post-intervention improvements were seen in depression (ES=0.74), anxiety (ES=0.46), positive affect (ES=0.72), and QLI (ES=0.44). Among caregivers (mean age 64, standard deviation 12, 58% female, 42% spouses or partners of the survivor), post- intervention improvements were seen in anxiety (ES=0.45) and negative affect (ES=0.42). CONCLUSIONS: CBCT exhibited preliminary evidence of efficacy versus CHE to improve HRQOL in survivors and ICs. This pilot trial informs future definitive trials to assess the benefits of CBCT for HRQOL among dyads.

Keywords: cancer survivors, informal caregivers, meditation, health- related quality of life