• Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion, and Shelley A Johns.
• Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
• Palliat Med. 2022 Jul 1; 36 (7): 110411171104-1117.

BackgroundFatigue often interferes with functioning in patients with advanced cancer, resulting in increased family caregiver burden. Acceptance and commitment therapy, a promising intervention for cancer-related suffering, has rarely been applied to dyads coping with advanced cancer.AimTo examine the feasibility, acceptability, and preliminary efficacy of acceptance and commitment therapy for patient-caregiver dyads coping with advanced gastrointestinal cancer. Primary outcomes were patient fatigue interference and caregiver burden.DesignIn this pilot trial, dyads were randomized to six weekly sessions of telephone-delivered acceptance and commitment therapy or education/support, an attention control. Outcomes were assessed at baseline and at 2 weeks and 3 months post-intervention.Setting/ParticipantsForty patients with stage III-IV gastrointestinal cancer and fatigue interference and family caregivers with burden or distress were recruited from two oncology clinics and randomized.ResultsThe eligibility screening rate (54%) and retention rate (81% at 2 weeks post-intervention) demonstrated feasibility. At 2 weeks post-intervention, acceptance and commitment therapy participants reported high intervention helpfulness (mean = 4.25/5.00). Group differences in outcomes were not statistically significant. However, when examining within-group change, acceptance and commitment therapy patients showed moderate decline in fatigue interference at both follow-ups, whereas education/support patients did not show improvement at either follow-up. Acceptance and commitment therapy caregivers showed medium decline in burden at 2 weeks that was not sustained at 3 months, whereas education/support caregivers showed little change in burden.ConclusionsAcceptance and commitment therapy showed strong feasibility, acceptability, and promise and warrants further testing.Trial RegistrationClinicalTrials.gov NCT04010227. Registered 8 July 2019, https://clinicaltrials.gov/ct2/show/NCT04010227?term=catherine+mosher&draw=2&rank=1.

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