Researchers from Mind Matters Research in Anchorage, Alaska, conducted a multi-site randomized trial to evaluate the impact on quality of life (QOL) benefits of an imagery-based group intervention titled 'Envision the Rhythms of Life'(ERL).
Breast cancer survivors more than 6 weeks post-treatment were randomized to attend either five weekly, 4-hour group sessions at a community center with therapist present (live delivery (LD), n = 48), or with the therapist streamed via telemedicine (telemedicine delivery (TD), n = 23), or to a waitlist control (WL) group (n = 47).
Weekly individual phone calls to encourage at-home practice began at session one and continued until the 3-month follow-up.
Seven self-report measures of QOL were examined at baseline, 1-month and 3-month post-treatment times, including health-related and breast cancer-specific QOL, fatigue, cognitive function, spirituality, distress, and sleep.
Linear multilevel modeling analysis revealed less fatigue, cognitive dysfunction, and sleep disturbance for both treatment groups, as compared with the waitlist group, across the follow-up (p's < 0.01).
Changes in fatigue, cognitive dysfunction, sleep disturbance, and health-related and breast cancer-related QOL were clinically significant. There were no differences between the live delivery and telemedicine delivery scores.
The investigators conclude that both the live and telemedicine delivered intervention resulted in improvements in multiple quality of life domains for breast cancer survivors, as compared with the wait list controls.
Further, there were no significant differences between Live Delivery and Telemedicine Delivery, suggesting that a telemedicine-delivered ERL intervention may represent an effective and viable option for cancer survivors in remote areas.
Citation: Freeman LW1, White R, Ratcliff CG, Sutton S, Stewart M, Palmer JL, Link J, Cohen L. A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: reducing symptoms and barriers to care. Psychooncology. 2014 Aug 22. doi: 10.1002/pon.3656.