Cited by 165Cancer survivorship and careDigital Mental Health InterventionsCancer-related cognitive impairment studies

The efficacy of Internet‐based cognitive behavioral therapy for severely fatigued survivors of breast cancer compared with care as usual: A randomized controlled trial

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Abrahams, Harriët J.G., Gielissen, Marieke F.M., Donders, Rogier R.T., Goedendorp, Martine M., van der Wouw, Agnes J., Verhagen, Constans A.H.H.V.M., Knoop, Hans·2017·Cancer

Abstract

BACKGROUND: Severe fatigue is a common and distressing symptom affecting approximately one in four survivors of breast cancer. The current study examined the efficacy of Internet‐based cognitive behavioral therapy (ICBT) for severe fatigue in survivors of breast cancer compared with care as usual (CAU). METHODS: The authors conducted a parallel‐group randomized controlled trial. Severely fatigued, disease‐free survivors of breast cancer who had completed cancer treatment at least 3 months previously were eligible. Participants were randomly allocated to ICBT or CAU using computer‐generated stratified block randomization. The primary outcome of fatigue severity was assessed at baseline and after 6 months, as were the secondary outcomes of functional impairment, psychological distress, and quality of life. Statistical effects were tested with analyses of covariance (intention‐to‐treat analysis). RESULTS: Participants were recruited between January 2014 and March 2016 and assigned to ICBT (66 patients) or CAU (66 patients). Compared with the participants who had received CAU, those who had received ICBT reported lower fatigue scores at 6 months (mean difference [Δ], 11.5; 95% confidence interval [95% CI], 7.7‐15.3) and a large effect size (Cohen d = 1.0), with the majority of patients (73%) demonstrating clinically significant improvement. ICBT also was found to lead to lower functional impairment (Δ, 297.8; 95% CI, 145.5‐450.1) and psychological distress scores (Δ, 5.7; 95% CI, 3.4‐7.9) and higher quality‐of‐life scores (Δ, 11.7; 95% CI, 5.8‐17.7) compared with CAU, with medium to large effect sizes (Cohen d = 0.6‐0.8). CONCLUSIONS: ICBT appears to be effective in reducing severe fatigue and related symptoms and meets the current need for easy accessible and more efficient evidence‐based treatment options for severely fatigued survivors of breast cancer. Cancer 2017;123:3825‐34. © 2017 American Cancer Society.

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  1. Vercoulen J, Alberts M, Bleijenberg G. De Checklist Individual Strength (CIS). Gedragstherapie. 1999;32:131-136.
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Authors
Abrahams, H. J. G., Gielissen, M. F. M., Donders, R. R. T., Goedendorp, M. M., van der Wouw, A. J., Verhagen, C. A. H. H. V. M., & Knoop, H.
Affiliations
  • Radboud University Medical Center (NL)
  • Amsterdam UMC Location University of Amsterdam (NL)
  • University Medical Center Groningen (NL)
  • Department of Internal Medicine VieCuri Medical Centre Venlo The Netherlands
Corresponding author
Knoop, Hans
Venue
Cancer
Publisher
Wiley
Published
2017-06-16
Volume
123
Issue
19
Pages
3825-3834
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
OpenAlex
W2626691418
Cited by
165
References
33
Citations by year
2026: 10 · 2025: 28 · 2024: 18 · 2023: 26 · 2022: 20 · 2021: 31 · 2020: 14 · 2019: 10 · 2018: 8
FWCI
3.86
Type
journal article
Language
en
Open access
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Funders
Dutch Pink Ribbon Foundation (2012.WO26.C139)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
internet-based cognitive behavioral therapy, cancer-related fatigue, breast cancer survivors, fatigue severity, functional disability, psychological distress, quality of life, digital mental health interventions
MeSH terms
Breast Neoplasms, Fatigue, Female, Humans, Middle Aged, Quality of Life, Stress, Psychological, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Survivors, Disease-Free Survival, Internet, Intention to Treat Analysis

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