Effectiveness of a guided online primary care intervention for fear of cancer recurrence: A randomised controlled trial.

Abstract

Fear of Cancer Recurrence (FCR) is highly prevalent among cancer survivors and leads to decreased quality of life and increased healthcare costs. We assessed the effectiveness of a guided online primary care intervention for FCR, compared to waiting list. In this RCT, participants were recruited online and randomised 1:1. All adults who finished successful curative cancer treatment between 3months and 10 years ago, wanted support for FCR, and had sufficient Dutch skills were eligible. The intervention consisted of a 10-week online programme and three to five video calling sessions with a trained mental health worker. After 6months, the control group received the same intervention. The primary outcome was the difference between the groups in the change in FCR severity from baseline (T0) to 6months (T2), measured online with the short form of the Fear of Cancer Recurrence Inventory. One hundred and seventy-three participants were enroled and randomised to the intervention (n=86) or control group (n=87). FCR severity dropped 2.1 points more in the intervention group than in the control group (2.7 points (SD=3.9) versus 0.6 points (SD=3.6), t(154)=3.4, p=0.0007). General mental well-being also improved significantly in the intervention group and remained stable in the control group. These improvements remained at 10months follow up. This easily accessible and relatively inexpensive intervention effectively reduces FCR and has potential to replace or precede existing more intensive psychological treatments, improving patients' access to care. The trial was prospectively registered in the Netherlands Trial Register on 25-02-2019 with number NL7573.