Oral Presentation COSA 2015 ASM

A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Implications and recommendations for developing an online self-help program. (#50)

Lisa Beatty 1 2 , Emma Kemp 1 , Phyllis Butow 3 , Afaf Girgis 4 , Nick Hulbert-Williams 5 , Penny Schofield 6 7 , Jane Turner 8 , Addie Wootten 9 , Janelle Levesque 4 , Bogda Koczwara 2
  1. College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
  2. Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, South Australia, Australia
  3. School of Psychology, University of Sydney, Sydney, New South Wales, Australia
  4. Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, New South Wales, Australia
  5. Department of Psychology, University of Chester, Chester, United Kingdom
  6. Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
  7. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  8. School of Medicine, University of Queensland, Herston, Queensland, Australia
  9. Australian Prostate Cancer Research, Richmond, Victoria, Australia

Aims:    While metastatic breast cancer (MBC) is incurable, many women live with the disease for a long time, with a median survival time of 2-4 years. A diagnosis of MBC brings significant adjustment challenges for women, and psychological morbidity rates typically range from 35-43%. Despite this, there is little data on how best to address these. A review conducted up until 2011 found only 10 intervention studies, largely delivered in a group format. This presentation aims to update the evidence-base for psychological interventions for women with MBC, and discuss how these can inform the development of an online self-help program. 

Methods: Four electronic bibliographic databases were searched: MEDLINE (OvidSP), PsychINFO (OvidSP), CINAHL (EBSCO), and SCOPUS; and reference lists of previous trials, systematic reviews and meta-analyses were examined. Selection criteria included: (a) Randomised controlled trial, (b) metastatic breast cancer, (c) psychotherapeutic intervention, and (d) outcomes related to either survival or psychosocial adjustment (distress, quality of life, sleep, fatigue, pain, social support).

Results: Initial database searches yielded 1063 results. After removing duplicates, titles and abstracts of 706 records were screened for possible inclusion against the eligibility criteria by two review authors independently, resulting in 29 full-texts being retrieved for further assessment. Of the full-texts retrieved for full-screening, 21 were therapist-administered (TA) group-interventions, 3 were TA individual-interventions, and 5 were low-intensity interventions (i.e., self-help / telephone / internet). Data was extracted and the study quality assessed using the Cochrane Collaboration risk of bias tool. Study characteristics, methodological quality, efficacy and survival outcomes will be discussed.

Conclusions: There remains a paucity of psychological interventions developed specifically for women with MBC, and novel delivery formats are warranted. The current findings will help to inform the development of an online self-help program for this population.