Abstract

BackgroundComputerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors. For patients presenting with cognitive symptoms in the early post-treatment phase, the benefit of CCT is unclear. To assess the possibility of testing the effectiveness of CCT in the early post-treatment period, our aim was to investigate the feasibility of an 8-week home-based, online CCT intervention among patients who have recently completed treatment for hematological malignancy.MethodsThis study was a single-arm, non-blinded, feasibility study. All participants were provided with the CCT intervention for an 8-week period. Feasibility was evaluated based on participant adherence and patient perceptions of the intervention, assessed through responses to an acceptability questionnaire and semi-structured interviews at the end of the intervention period.ResultsThe feasibility study included 19 patients who had completed treatment for hematological malignancy at a Canadian tertiary cancer center. Adherence to the CCT intervention was limited, with only one participant meeting the criteria for intervention adherence. At the end of the intervention period, participants characterized the program as easy to follow (92%) and felt well-prepared for how to complete the exercises (100%). In semi-structured interviews, participants highlighted post-treatment barriers to intervention adherence that included symptom burden and competing time demands. Participants also suggested improvements to the intervention that could help maintain adherence despite these barriers, such as fostering a sense of accountability, providing personalized feedback and coaching, and enabling opportunities for peer support.ConclusionsParticipation in CCT can be challenging in the post-treatment period for hematological cancers. Further research on the effectiveness of CCT in this setting may require the implementation of strategies that support participants’ engagement with the intervention in the context of symptoms and competing demands, such as establishing a minimum dose requirement and integrating approaches to help promote and sustain motivation.

Highlights

  • Computerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors

  • What uncertainties existed regarding the feasibility? Computerized cognitive training programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors

  • What are the key feasibility findings? Adherence to early intervention with CCT in the post-treatment period may be limited by barriers, such as symptoms and competing time demands, but may be enhanced with greater motivational support

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Summary

Introduction

Computerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors. For patients presenting with cognitive symptoms in the early post-treatment phase, the benefit of CCT is unclear. To assess the possibility of testing the effectiveness of CCT in the early post-treatment period, our aim was to investigate the feasibility of an 8-week home-based, online CCT intervention among patients who have recently completed treatment for hematological malignancy. Cancer-related cognitive impairment, comprising difficulties with short-term memory, processing speed, and complex attention/working memory, has been documented after treatment for a range of cancers, including hematological malignancies. Treatment of hematological malignancies, such as lymphoma and multiple myeloma, comprise a range of systemic treatments that have been associated with cognitive effects, including chemotherapy [1,2,3] and stem cell transplantation [4]. In a study of 715 hematological cancer survivors, “coping with having a bad memory or lack of focus” was the 2nd most frequently endorsed “high/very high” unmet need [16]

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