Cancer and Aging: Reflections for Elders (CARE): A pilot randomized controlled trial of a psychotherapy intervention for older adults with cancer Journal Article

Authors: Nelson, C. J.; Saracino, R. M.; Roth, A. J.; Harvey, E.; Martin, A.; Moore, M.; Marcone, D.; Poppito, S. R.; Holland, J.
Article Title: Cancer and Aging: Reflections for Elders (CARE): A pilot randomized controlled trial of a psychotherapy intervention for older adults with cancer
Abstract: Objective: Cancer and Aging: Reflections for Elders (CARE) is a novel, telephone-delivered intervention designed to alleviate distress in older cancer patients. This pilot randomized controlled trial tested the feasibility and initial efficacy of CARE, drawing from age-appropriate developmental themes and well-established coping theory. Method: Eligible patients were ≥70 years old; ≥6 months post-diagnosis of lung, prostate, breast, lymphoma, or gynecological cancer; on active cancer treatment or within 6 months of ending cancer treatment; and had elevated scores on the Distress Thermometer (≥4) or Hospital Anxiety and Depression Scale (≥6). Participants completed five sessions of psychotherapy over 7 weeks with assessments at study entry, post-intervention, and 2 months post-intervention. Primary outcomes were feasibility and initial efficacy on anxiety and depression; secondary outcomes included demoralization, coping, loneliness, and spiritual well-being. Results: Fifty-nine participants were randomized to either the CARE arm (n = 31) or the enhanced Social Work Control arm (n = 28). The intervention was feasible and tolerable, meeting a priori criteria for rates of eligibility, acceptance, retention, assessment, and treatment fidelity. Upon completion of the intervention, participants in the CARE arm demonstrated lower mean depression scores (d = 0.58 [CI: 0.04-1.12], P = 0.01) and trended towards increased coping-planning (d = 0.30 [CI: −0.83 to 0.24], P = 0.18). Promising trends in anxiety (d = 0.41 [CI: −0.17 to 0.98], P = 0.10) emerged at 2 months post-intervention; effects for coping-planning dissipated. Conclusion: These pilot data suggest the CARE intervention is feasibly delivered, potentially impacts important psychosocial variables, and is accessible for older, frail patients with cancer. Future research will evaluate this intervention on a larger scale. © 2018 John Wiley & Sons, Ltd.
Keywords: counseling; oncology; depression; aging; anxiety; intervention; geriatric; cancer
Journal Title: Psycho-Oncology
Volume: 28
Issue: 1
ISSN: 1057-9249
Publisher: John Wiley & Sons  
Date Published: 2019-01-01
Start Page: 39
End Page: 47
Language: English
DOI: 10.1002/pon.4907
PUBMED: 30296337
PROVIDER: scopus
Notes: Article -- Export Date: 1 February 2019 -- Source: Scopus
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MSK Authors
  1. Anne H Martin
    7 Martin
  2. Andrew J Roth
    85 Roth
  3. Christian Nelson
    254 Nelson
  4. Jimmie C B Holland
    225 Holland
  5. Rebecca Mary James
    19 James
  6. Elizabeth B Harvey
    1 Harvey