SUrvivors' Rehabilitation Evaluation after CANcer (SURECAN): using Acceptance & Commitment Therapy plus physical activity and work support (ACT+) for those who choose them, to help people living with and beyond cancer

Conference:

SAPC ASM 2019 - Exeter

Talk Code:

1C.6a

Presenter:

Stephanie Taylor

Co-authors:

Dipesh Gopal (1), Trudie Chalder (2), Imran Khan (1), Elisavet Moschopoulou (1), Sheila Donnovan (1), Steph Taylor (1) on behalf of the SURECAN Investigators

Author institutions:

1. Queen Mary University of London, 2. Kings College London

Problem

Two million people in the UK are living with and beyond cancer (here called “cancer survivors” for brevity). Around a third have a diminished quality of life (QoL). Cancer survivors are also much less likely to be in employment than their peers who have not experienced cancer. Previous research suggests that the psychological intervention, cognitive behavioural therapy, and exercise may improve the QoL of cancer survivors.We will develop an intervention for cancer survivors based on Acceptance and Commitment Therapy (ACT) - a psychological intervention that puts patients’ views about what they value most in their lives at the heart of the therapy, in order to improve their quality of life. ACT helps patients to accept what they cannot change (e.g. that cancer might recur) and commit themselves to goals they are able to achieve, based on their own values (e.g. becoming closer to loved ones). Since we know that exercise is helpful and work is important to many patients, we will integrate ACT with options for physical activity and work support, if these are deemed important by the patient (thus our intervention is: ACT+). Aim: To develop, pilot and evaluate a novel, person-centred, psychological intervention (“ACT+”), based on Acceptance and Commitment Therapy, for people who have received or are receiving treatment for cancer with curative intent but are experiencing poor quality of life.

Approach

Our methodology involves several connected workstreams:1) A qualitative meta-ethnographic synthesis of cultural influences on psychological interventions for cancer survivors, to help us design ACT+ to be acceptable and useful in culturally diverse populations.2) Development and refinement of ACT+ therapy: using interviews with patients, therapists, and clinicians in addition to training therapies to deliver ACT+ in a pre-pilot study.3) A multi-centre RCT of ACT+ versus routine treatment (n=344) in patients who are living with and beyond breast, colorectal, prostate, haematological and head and neck cancers, (including an internal pilot (n=45) to test recruitment and running).4) A therapy process evaluation including qualitative methods to explore experience of ACT+ amongst participants and therapists and a quantitative assessment of moderators and mediators of treatment effect.

Findings

The project is ongoing, we will present findings from the qualitative work and pre-pilot study and how these have influenced the development and delivery of ACT+ therapy.

Consequences

We hope that by the trial end in 2023, we will be able to determine if ACT+ is effective, safe, culturally acceptable, and cost-effective in improving the well-being of those living with and beyond cancer.

Submitted by:

Dipesh Gopal

Funding acknowledgement:

Funded by the NIHR Programme Grants for Applied Research (RP-PG-0616-20002). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.