A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Context matters

Lisa Beatty, Emma Kemp, Phyllis Butow, Afaf Girgis, Penelope Ellen Schofield, Jane Turner, Nicholas J. Hulbert-Williams, Janelle V. Levesque, Bogda Koczwara

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: To summarise the evidence-base of psychological interventions for women with metastatic breast cancer, by mode of delivery (group, individual, or low-intensity interventions). To synthesise data regarding core intervention-elements (eg, intervention duration) and context factors (trial setting, uptake and adherence, and demographic characteristics). Methods: Four databases were searched (inception-May 2016): MEDLINE (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCO), and SCOPUS; reference lists were examined for additional publications. Grey literature was excluded. Outcome data were extracted for survival, distress, quality of life, coping, sleep, fatigue, and/or pain and summarised through narrative synthesis. Results: Fifteen randomised clinical trials (RCTs), reported across 23 articles, met inclusion criteria: 7 groups, 4 individuals, and 4 low-intensity interventions. Overall, interventions improved distress (8/13 RCTs), coping (4/5 RCTs), and pain (4/5 RCTs). No evidence of survival benefit was found. For remaining outcomes, evidence was either insufficient, or too mixed to draw conclusions. Group programs had the strongest evidence-base for efficacy; individual and low-intensity therapy had insufficient evidence to form conclusions. Group interventions had longest intervention durations and lowest uptake and adherence; low-intensity interventions had shortest durations and highest uptake and adherence. Disparities in uptake, adherence, and reach were evident, with the demographic profile of participants polarised to young, Caucasian, English-speaking, partnered women. Conclusions: There remains a paucity of psychological interventions for women with metastatic breast cancer. Those that exist have an inconsistent evidence-base across the range of patient-reported outcomes. Further research is needed to evaluate accessible delivery formats that ensure efficacy as well as uptake.

LanguageEnglish
Pages34-42
Number of pages9
JournalPsycho-Oncology
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 2018
Externally publishedYes

Keywords

  • Cancer
  • Metastatic breast cancer
  • Oncology
  • Psychological interventions
  • Systematic review
  • Treatment modality

Cite this

Beatty, L., Kemp, E., Butow, P., Girgis, A., Schofield, P. E., Turner, J., ... Koczwara, B. (2018). A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Context matters. Psycho-Oncology, 27(1), 34-42. https://doi.org/10.1002/pon.4445
Beatty, Lisa ; Kemp, Emma ; Butow, Phyllis ; Girgis, Afaf ; Schofield, Penelope Ellen ; Turner, Jane ; Hulbert-Williams, Nicholas J. ; Levesque, Janelle V. ; Koczwara, Bogda. / A systematic review of psychotherapeutic interventions for women with metastatic breast cancer : Context matters. In: Psycho-Oncology. 2018 ; Vol. 27, No. 1. pp. 34-42.
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abstract = "Objectives: To summarise the evidence-base of psychological interventions for women with metastatic breast cancer, by mode of delivery (group, individual, or low-intensity interventions). To synthesise data regarding core intervention-elements (eg, intervention duration) and context factors (trial setting, uptake and adherence, and demographic characteristics). Methods: Four databases were searched (inception-May 2016): MEDLINE (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCO), and SCOPUS; reference lists were examined for additional publications. Grey literature was excluded. Outcome data were extracted for survival, distress, quality of life, coping, sleep, fatigue, and/or pain and summarised through narrative synthesis. Results: Fifteen randomised clinical trials (RCTs), reported across 23 articles, met inclusion criteria: 7 groups, 4 individuals, and 4 low-intensity interventions. Overall, interventions improved distress (8/13 RCTs), coping (4/5 RCTs), and pain (4/5 RCTs). No evidence of survival benefit was found. For remaining outcomes, evidence was either insufficient, or too mixed to draw conclusions. Group programs had the strongest evidence-base for efficacy; individual and low-intensity therapy had insufficient evidence to form conclusions. Group interventions had longest intervention durations and lowest uptake and adherence; low-intensity interventions had shortest durations and highest uptake and adherence. Disparities in uptake, adherence, and reach were evident, with the demographic profile of participants polarised to young, Caucasian, English-speaking, partnered women. Conclusions: There remains a paucity of psychological interventions for women with metastatic breast cancer. Those that exist have an inconsistent evidence-base across the range of patient-reported outcomes. Further research is needed to evaluate accessible delivery formats that ensure efficacy as well as uptake.",
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Beatty, L, Kemp, E, Butow, P, Girgis, A, Schofield, PE, Turner, J, Hulbert-Williams, NJ, Levesque, JV & Koczwara, B 2018, 'A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Context matters' Psycho-Oncology, vol. 27, no. 1, pp. 34-42. https://doi.org/10.1002/pon.4445

A systematic review of psychotherapeutic interventions for women with metastatic breast cancer : Context matters. / Beatty, Lisa; Kemp, Emma; Butow, Phyllis; Girgis, Afaf; Schofield, Penelope Ellen; Turner, Jane; Hulbert-Williams, Nicholas J.; Levesque, Janelle V.; Koczwara, Bogda.

In: Psycho-Oncology, Vol. 27, No. 1, 01.2018, p. 34-42.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Levesque, Janelle V.

AU - Koczwara, Bogda

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N2 - Objectives: To summarise the evidence-base of psychological interventions for women with metastatic breast cancer, by mode of delivery (group, individual, or low-intensity interventions). To synthesise data regarding core intervention-elements (eg, intervention duration) and context factors (trial setting, uptake and adherence, and demographic characteristics). Methods: Four databases were searched (inception-May 2016): MEDLINE (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCO), and SCOPUS; reference lists were examined for additional publications. Grey literature was excluded. Outcome data were extracted for survival, distress, quality of life, coping, sleep, fatigue, and/or pain and summarised through narrative synthesis. Results: Fifteen randomised clinical trials (RCTs), reported across 23 articles, met inclusion criteria: 7 groups, 4 individuals, and 4 low-intensity interventions. Overall, interventions improved distress (8/13 RCTs), coping (4/5 RCTs), and pain (4/5 RCTs). No evidence of survival benefit was found. For remaining outcomes, evidence was either insufficient, or too mixed to draw conclusions. Group programs had the strongest evidence-base for efficacy; individual and low-intensity therapy had insufficient evidence to form conclusions. Group interventions had longest intervention durations and lowest uptake and adherence; low-intensity interventions had shortest durations and highest uptake and adherence. Disparities in uptake, adherence, and reach were evident, with the demographic profile of participants polarised to young, Caucasian, English-speaking, partnered women. Conclusions: There remains a paucity of psychological interventions for women with metastatic breast cancer. Those that exist have an inconsistent evidence-base across the range of patient-reported outcomes. Further research is needed to evaluate accessible delivery formats that ensure efficacy as well as uptake.

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