Psychosocial interventions for HCT survivors
| Author . | Sample . | Study design . | Intervention . | Measures . | Findings . |
|---|---|---|---|---|---|
| Depression/anxiety | |||||
| Copeland et al47 | n = 20, allogeneic HCT, >18 years of age | Single-arm prospective pre-HCT, day 0, +14, +30, +60 | Weekly collaborative care meetings with HCT clinicians and psychiatrist, review case and provide pharmacologic recommendations and psychosocial counseling referrals | Hospital Anxiety and Depression Scale | Anxiety decreased and depression decreased (pre- to day +60). |
| Kim et al48 | n = 40, mean age 59.2 years | Randomized (intervention or information control) pre- and post assessment | Digital storytelling—four 3-minute personal/emotionally rich stories about post-HCT care | POMS subscales for depression and anxiety, PROMIS Social Support scale | Perceived social support increased for intervention and decreased for control. Anxiety and depression improved with time for both. |
| Coping/stress | |||||
| Balck et al49 | n = 91, allogeneic and autologous, >18 years of age | Randomized (intervention or control group) pre-HCT, day +11, +23 | Problem-solving training | HADS, SCL-9, Brief Cope, Social Problem-Solving Inventory-R, Questions of Pain, NCCN Distress Thermometer | Anxiety, distress, pain, stress were lower and active coping better with intervention. Better able to reduce negative orientation and problem-solve with intervention. |
| Somers et al50 | n = 36, allogeneic and autologous (83%), mean age 56 years | Randomized (intervention or usual treatment) pre- and post assessment | Mobile pain-coping skills: website with personalized messages and pain assessment activity. Materials (handouts, videos, audio files) about pain-coping advice from patients and how to apply pain-coping skills | Brief pain inventory, pain disability index, pain subscale of the chronic pain self-efficacy scale, PROMIS Fatigue scale, FACT well-being scale, 2MWT | Intervention with improved pain, self-efficacy, and on the 2MWT, and no improvement in the control group. Changes in pain disability and fatigue in both groups; effect sizes were larger for the intervention group. No changes in pain severity in either group. |
| Majhail et al39 | n = 458, allogeneic (48%) intervention arm, (44%) control arm, median age 59 years for both arms | Randomized (intervention or control) pre- and post assessment (6 months) | Survivorship care plan | CSI, CTXD, Knowledge of Transplant Exposures, Health Care Utilization, SF-12 | Intervention—lower distress scores at 6 months and greater mental health scores |
| Syrjala et al40 Syrjala et al51 Yi et al52 | n = 755, allogeneic and autologous (27%), mean age 51 years | Randomized (intervention or intervention + problem- solving training or control—delayed access to intervention) pre- and post assessment (6 months) | INSPIRE—tailored web page with topics (1) lift mood, reduce fatigue, boost health; (2) self-care tips and tools; (3) tailored care guidelines; (4) forum for posting experiences and for input; (5) resource list problem-solving—focus on problems and goal setting with psychologists (>4 sessions) | CTXD, SCL-90-R Depression Scale, SF-36, FSI | INSPIRE+ problem-solving training more likely to improve in distress than controls. Male, age <40 years, African Americans were less likely to enroll. Engagement did not differ by race, education, income, rural/urban residence, computer experience, donor type, or presence of depression. |
| Cognitive/developmental | |||||
| Ferraro et al53 | n = 110 | Feasibility study of screening at pre-HCT, day +100, 2 years, 5 years post HCT | MoCA, BACH | Neurocognitive screening is feasible to do prior to and post transplant. | |
| Hoodin et al54 | n = 9, allogeneic HCT, mean age 53 years, control cohorts— concurrent longitudinal study | Ancillary study and feasibility of assessing vorinostat, cognitive function, and QOL baseline, day 30, 100, 160 | Vorinostat + Tac + MTX for GVHD prophylaxis | Cogstate, PHQ-9, GAD-7, FACT-General | Neurocognitive function, depression, anxiety, quality of life did not differ across time. Modeling—neurocognitive function in vorinostat patients compared to auto controls was equivalent and better than allo controls. |
| Author . | Sample . | Study design . | Intervention . | Measures . | Findings . |
|---|---|---|---|---|---|
| Depression/anxiety | |||||
| Copeland et al47 | n = 20, allogeneic HCT, >18 years of age | Single-arm prospective pre-HCT, day 0, +14, +30, +60 | Weekly collaborative care meetings with HCT clinicians and psychiatrist, review case and provide pharmacologic recommendations and psychosocial counseling referrals | Hospital Anxiety and Depression Scale | Anxiety decreased and depression decreased (pre- to day +60). |
| Kim et al48 | n = 40, mean age 59.2 years | Randomized (intervention or information control) pre- and post assessment | Digital storytelling—four 3-minute personal/emotionally rich stories about post-HCT care | POMS subscales for depression and anxiety, PROMIS Social Support scale | Perceived social support increased for intervention and decreased for control. Anxiety and depression improved with time for both. |
| Coping/stress | |||||
| Balck et al49 | n = 91, allogeneic and autologous, >18 years of age | Randomized (intervention or control group) pre-HCT, day +11, +23 | Problem-solving training | HADS, SCL-9, Brief Cope, Social Problem-Solving Inventory-R, Questions of Pain, NCCN Distress Thermometer | Anxiety, distress, pain, stress were lower and active coping better with intervention. Better able to reduce negative orientation and problem-solve with intervention. |
| Somers et al50 | n = 36, allogeneic and autologous (83%), mean age 56 years | Randomized (intervention or usual treatment) pre- and post assessment | Mobile pain-coping skills: website with personalized messages and pain assessment activity. Materials (handouts, videos, audio files) about pain-coping advice from patients and how to apply pain-coping skills | Brief pain inventory, pain disability index, pain subscale of the chronic pain self-efficacy scale, PROMIS Fatigue scale, FACT well-being scale, 2MWT | Intervention with improved pain, self-efficacy, and on the 2MWT, and no improvement in the control group. Changes in pain disability and fatigue in both groups; effect sizes were larger for the intervention group. No changes in pain severity in either group. |
| Majhail et al39 | n = 458, allogeneic (48%) intervention arm, (44%) control arm, median age 59 years for both arms | Randomized (intervention or control) pre- and post assessment (6 months) | Survivorship care plan | CSI, CTXD, Knowledge of Transplant Exposures, Health Care Utilization, SF-12 | Intervention—lower distress scores at 6 months and greater mental health scores |
| Syrjala et al40 Syrjala et al51 Yi et al52 | n = 755, allogeneic and autologous (27%), mean age 51 years | Randomized (intervention or intervention + problem- solving training or control—delayed access to intervention) pre- and post assessment (6 months) | INSPIRE—tailored web page with topics (1) lift mood, reduce fatigue, boost health; (2) self-care tips and tools; (3) tailored care guidelines; (4) forum for posting experiences and for input; (5) resource list problem-solving—focus on problems and goal setting with psychologists (>4 sessions) | CTXD, SCL-90-R Depression Scale, SF-36, FSI | INSPIRE+ problem-solving training more likely to improve in distress than controls. Male, age <40 years, African Americans were less likely to enroll. Engagement did not differ by race, education, income, rural/urban residence, computer experience, donor type, or presence of depression. |
| Cognitive/developmental | |||||
| Ferraro et al53 | n = 110 | Feasibility study of screening at pre-HCT, day +100, 2 years, 5 years post HCT | MoCA, BACH | Neurocognitive screening is feasible to do prior to and post transplant. | |
| Hoodin et al54 | n = 9, allogeneic HCT, mean age 53 years, control cohorts— concurrent longitudinal study | Ancillary study and feasibility of assessing vorinostat, cognitive function, and QOL baseline, day 30, 100, 160 | Vorinostat + Tac + MTX for GVHD prophylaxis | Cogstate, PHQ-9, GAD-7, FACT-General | Neurocognitive function, depression, anxiety, quality of life did not differ across time. Modeling—neurocognitive function in vorinostat patients compared to auto controls was equivalent and better than allo controls. |