e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Conducting a feasibility pilot of a web-based psychosocial program for women with metastatic breast cancer during COVID-19: Recruitment and retention to Finding My Way-Advanced. (#354)

Lisa Beatty 1 , Emma Kemp 1 , Phyllis Butow 2 , Afaf Girgis 3 , Jane Turner 4 , Penelope Schofield 5 , Nick Hulbert-Williams 6 , Billingsley Kaambwa 1 , Finding My Way-Advanced Steering Group 1 , Bogda Koczwara 1 7
  1. Flinders University, Adelaide, SA, Australia
  2. Sydney University, Sydney, NSW
  3. University of NSW, Sydney, NSW
  4. University of Queensland, Brisbane, QLD
  5. Swinburne University of Technology, Melbourne, VIC
  6. University of Chester, Chester, United Kingdom
  7. Medical Oncology, Flinders Medical Centre, Adelaide, SA, Australia

Aims: While digital psycho-oncology interventions are increasing used, few have targeted patients with advanced disease. To address this gap, our group co-designed Finding My Way – Advanced (FMW-A), a 6-module self-guided CBT-based program for women with metastatic breast cancer (MBC). The present study aimed to assess the feasibility of this program.

Methods: A single-site pilot randomised controlled trial (RCT) was conducted. Participants were recruited between 27/2/2020-30/6/2021, via direct clinician approach, professional networks and social media. Participants were eligible if diagnosed with metastatic breast cancer, had a life expectancy of at least 6 months, were aged 18 years or over, had internet and email access, and sufficient English language proficiency. Participants were randomised to either the intervention (FMW-A plus usual-care) or usual-care control (“Hope and Hurdles” kit, provided by Breast Cancer Network Australia to all women following diagnosis of MBC). Feasibility outcomes were: recruitment indices (recruitment rates; uptake rates), and retention (program-adherence: modules completed; and attrition: the percentage of participants who did not complete post-treatment survey). Psychosocial outcomes were collected as potential indicators of efficacy.

Results: The recruitment rate over time was delayed because of COVID19 pandemic, amounting to 2.3 per month and the target was not reached (n=35 recruited; n=40 target). Of those approached, the uptake rate was high (n=35/61; 57.3%), but varied by recruitment method. Adherence was modest (M: 2.3 modules accessed per user), and research attrition was moderate, with 50.0% completing their post-treatment surveys (to date). While social media was effective in improving recruitment, this did not correspondingly improve retention.

Conclusions: These results demonstrate the challenges of conducting a trial with this population who face symptom burden (e.g. fatigue, memory and concentration difficulty) and family stressors, amplified by the COVID-19 pandemic, and provide realistic estimates for future psychosocial clinical trials.