Gotay, C.C., Moinpour, C.M., Unger, J.M., Jiang, C.S., Coleman, D., Martino, S. . . . Albain, K.S. (2007). Impact of a peer-delivered telephone intervention for women experiencing a breast cancer recurrence. Journal of Clinical Oncology, 25 (15), 2093–2098.

To evaluate the effects a brief telephone intervention on women experiencing a recurrence of breast cancer

Women were randomly assigned to either a telephone-intervention group (TG) or a control group (CG). TG received 4–8 counseling/information sessions by telephone at weekly intervals. Session content reflected primary patient concerns and common domains from a quality-of-life (QOL) model. After the first session, patients received an information packet. The packet consisted primarily of National Cancer Institute pamphlets. Counselors were breast cancer recurrence survivors at least one year postrecurrence. Assessments were completed at baseline, three months, and six months.

The study was conducted by SWOG (formerly the Southwest Oncology Group)—an organization, supported by the National Cancer Institute, that conducts clinical trials relating to cancer in adults.

• The sample was composed of 305 women experiencing the first recurrence of breast cancer.
• Characteristics of participants in both groups were well balanced except that, in the TG group, more patients received chemotherapy; in the CG group, more patients received hormone therapy.

Multisite

• Cancer Rehabilitation Evaluation System-Short Form (CARES-SF), to measure emotional well-being
• Center for Epidemiological Studies Depression Scale (CESD), to measure depression

Secondary-outcome assessments:

• Four-item scale as proposed by Reynolds et al., to measure social support
• Life Orientation Test (LOT), to measure optimism and pessimism
• Three-point question, to measure surprise regarding recurrence
• Sense of Coherence Scale (Antonovsky), to measure sense of coherence.

Support services utilized and satisfaction with the telephone intervention were requested.

The telephone intervention was feasible and well accepted, but authors noted no benefits associated with the intervention, in regard to either emotional well-being or depressive symptoms. Patient distress started and remained very high in this sample. Statistically significant was the fact that more CG patients progressed during the six months of the study than did members of the TG group.

This is a well-designed RCT with adequate sample size; however, the study’s generalizability is unclear, given that the patients came from multiple institutions across the United States. The catchment cannot be precisely described, and characteristics of refusing patients were not reported. This sample included high levels of psychological and disease-related disability, and telephone calls from a nonprofessional may not have been an appropriate means of modifying patient distress. The study presents no significant findings.