Real World Outcomes of a Condensed Classroom-Based Cognitive Behavioral Therapy for Cancer-Related Cognitive Impairment.

BACKGROUND

Cancer-related cognitive impairment (CRCI) affects a large proportion of cancer survivors and adversely affects quality of life (QoL). While there is no established CRCI treatment, a cognitive-behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), has evidence of efficacy in improving self-reported and objective neurocognitive outcomes. However, not all people with CRCI require a full course of MAAT (8 visits).

AIMS: We condensed MAAT into an educational class (4 1-h meetings) as a "stepped care" approach to address CRCI in a busy clinical oncology care setting. Our goal with this quality improvement project was to offer brief, accessible CRCI care and evaluate self-reported cognitive function.

METHODS

"MAAT-Class" utilizes discussion, problem-solving and a PowerPoint presentation emphasizing CRCI education, self-awareness, self-regulation/emotional coping, and compensatory strategies. All participants use a MAAT workbook. Self-report measures assessing cognitive symptoms, emotional function, coping and sleep were administered before and after MAAT-Class.

RESULTS

Twenty-two adult participants with diverse cancer diagnoses (breast, leukemia/lymphoma, CNS tumor) provided complete data. Significant improvements were observed in Perceived Cognitive Impairments (p < 0.05; d = 0.79), Impact on QoL (p < 0.05; d = 0.39), Perceived Cognitive Abilities (p < 0.05; d = 0.88), relaxation skills (p < 0.001; d = 0.77) and coping confidence (p < 0.001; d = 0.77).

CONCLUSIONS

A condensed classroom-based version of MAAT demonstrated improvements in perceived cognitive impairments, QoL and coping. This first-step clinical educational approach could potentially and efficiently help inform patients with CRCI and improve QoL outcomes. Administering MAAT-Class via telehealth could potentially help survivorship care access. However, evaluation with a randomized study is necessary to definitively answer questions of efficacy.