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Hematologic MalignancyNCT04736056

Mindfulness and CBT for Sleep

A study testing Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills in people with Hematologic Malignancy, run by Duke University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Patients with hematologic cancer frequently report significant difficulties with sleep in the months after discharge from inpatient chemotherapy. Poor sleep quality can contribute to and perpetuate problems with daytime fatigue, pain, and distress that are common among patients with hematologic cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hematologic Malignancy
What is being tested?
Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills
Could I receive a placebo?
No, everyone receives an active treatment
How many people
57 participants
Where
1 siteUnited States
Study dates
1 Apr 2021to 19 May 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • an initial or recurrent diagnosis of hematologic malignancy
  • within 8 weeks of discharge home after inpatient chemotherapy or CAR-T therapy
  • total score of 8 or greater on the Insomnia Severity Index (ISI)
  • score of 5 or greater on the MD Anderson Symptom Inventory Scale for "worst" fatigue, pain, or distress, and report that these symptoms interfered with at least two activities of living (i.e., general activity, mood, work) in the last week at 3 or greater on a 0="Did not interfere" to 10="Interfered completely" scale
  • ability to speak and read English, and hearing and vision that allows for completion of sessions and assessments

Who cannot join

  • reported or suspected cognitive impairment subsequently informed by a Folstein Mini-Mental Status Examination of <25
  • presence of a serious psychiatric (e.g., schizophrenia, suicidal intent) or medical condition (e.g., seizure disorder, narcolepsy) indicated by medical chart, treating oncologist or other medical provider that would contraindicate safe participation
  • expected survival of 6 months or less

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Duke Cancer Institute

    Durham, North Carolina, 27710

Other trials in United States

About this study

Official title: Mindfulness and Cognitive Behavioral Therapy for Sleep in Cancer

Patients with hematologic cancer frequently report significant difficulties with sleep in the months after discharge from inpatient chemotherapy. Poor sleep quality can contribute to and perpetuate problems with daytime fatigue, pain, and distress that are common among patients with hematologic cancer. There is a need for behavioral interventions that address insomnia and daytime fatigue, pain, and distress once hematologic cancer patients have returned home after inpatient chemotherapy. Mindfulness-Based Therapy for Insomnia (MBTI) is a new approach to treating insomnia. This group-based intervention combines sleep restriction and stimulus control with mindfulness principles and exercises to reduce worry and promote positive responses to insomnia. To date, MBTI has not been applied to patients with hematologic cancer. If MBTI is to meet the needs of hematologic cancer patients, it must be adapted in several ways. First, because hematologic cancer patients are immunosuppressed, MBTI needs to be adapted for one-to-one delivery. Second, because hematologic cancer patients experience significant daytime fatigue, pain, and distress, MBTI needs to be adapted to include systematic training in coping skills for these symptoms. The investigators propose to develop and pilot test an adapted MBTI (MBTI+) protocol for hematologic cancer patients reporting insomnia, fatigue, pain, and/or distress after inpatient chemotherapy. The study will be conducted in two phases. In Phase I, the study team will use focus groups with hematologic cancer patients and hematology-oncology providers to guide development along with user testing with hematologic cancer patients reporting insomnia and daytime symptoms of fatigue, pain, and/or distress. Phase II will involve a small single-arm pilot to examine the feasibility, acceptability, and examine pre- to post-intervention primary (insomnia) and secondary (fatigue, pain, distress, mindfulness, self-efficacy) outcomes of the MBTI+ protocol. MBTI+ will consist of six, 60- to 75-minute therapy sessions delivered either in-person or via videoconferencing technology. Study measures will be collected at baseline, immediately post-intervention, and 1-month post-intervention.

Being tested
Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills
Medical subject headings
Hematologic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping SkillsBehavioural

    Mindfulness-based sleep strategies and cognitive-behavioral symptom coping skills.

Study groups in NCT04736056
Study groupRoleWhat they receive
Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping SkillsExperimentalMindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills (MBTI+) The MBTI+ intervention will train participants in mindfulness-based sleep strategies and behavioral symptom management techniques. The MBTI+ intervention will consist of 6 weekly sessions that will last between 60 and 75 minutes.
Receives: Behavioral: Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility as Measured by Number of Participants Accrued to Single-arm Pilot

    Treatment feasibility will be indicated by meeting target study accrual (i.e., 30 participants consented and enrolled for single-arm pilot).

    Measured: 12 weeks (post-intervention)

  2. Feasibility as Measured by Study Attrition at Post-intervention Follow-up

    Treatment feasibility will be indicated by less than or equal to 20% study attrition at post-intervention follow-up.

    Measured: 12 weeks (post-intervention)

  3. Feasibility as Measured by Adherence to the Intervention

    Adherence will be indicated by at least 80% of the participants completing all 6 intervention sessions.

    Measured: 12 weeks (post-intervention)

  4. Acceptability as Measured by the Client Satisfaction Questionnaire (CSQ)

    Acceptability will be indicated by at least 80% of participants who completed the intervention protocol reporting satisfaction with the protocol on the CSQ (i.e., mean of at least 3 out of 4). The CSQ is a 10 item self-report measure with item responses ranging from 1 to 4, with higher scores indicating greater satisfaction. All 10 items were averaged to obtain a mean score (range: 1 - 4). The number of participants with a mean CSQ score of at least 3 out of 4 was tabulated and then converted to a percentage of patients.

    Measured: 12 weeks (post-intervention)

  5. Insomnia Symptoms as Measured by the Insomnia Symptom Index (ISI)

    Insomnia symptoms will be measured using the 7-item Insomnia Symptom Index (ISI). Scores on the ISI range from 0 to 28 with higher scores indicating more severe insomnia symptoms.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

Secondary outcomes (13)
  1. Fatigue Severity as Measured by the Fatigue Symptom Inventory (FSI)

    Fatigue symptoms will be assessed using the 11-item Fatigue Symptom Inventory (FSI). Four items measure fatigue severity. Seven items measure fatigue interference. Scores on the FSI for fatigue severity and interference range from 0 to 10 with higher scores indicating higher fatigue severity and interference.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  2. Fatigue Interference as Measured by the Fatigue Symptom Inventory (FSI)

    Fatigue symptoms will be assessed using the 11-item Fatigue Symptom Inventory (FSI). Four items measure fatigue severity. Seven items measure fatigue interference. Scores on the FSI for fatigue severity and interference range from 0 to 10 with higher scores indicating higher fatigue severity and interference.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  3. Pain Severity as Measured by the Brief Pain Inventory-Short Form (BPI-SF)

    Pain symptoms will be measured using the 11-item Brief Pain Inventory-Short Form (BPI-SF). Four items measure pain severity. Scores on the BPI-SF for pain severity range from 0 to 10 with higher scores indicating higher pain severity.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  4. Pain Interference as Measured by the Brief Pain Inventory-Short Form (BPI-SF)

    Pain symptoms will be measured using the 11-item Brief Pain Inventory-Short Form (BPI-SF). Seven items measure pain interference. Scores on the BPI-SF for pain interference range from 0 to 10 with higher scores indicating higher pain interference.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  5. Severity of Anxiety Symptoms as Measured by the Hospital Anxiety and Depression Scale (HADS)

    Anxiety symptoms will be measured using the 14-item Hospital Anxiety and Depression Scale (HADS). Seven items measure severity of anxiety symptoms. Scores for anxiety symptom severity range from 0 to 21 with higher scores indicating more severe anxiety.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  6. Severity of Depressive Symptoms as Measured by the Hospital Anxiety and Depression Scale (HADS)

    Depressive symptoms will be measured using the 14-item Hospital Anxiety and Depression Scale (HADS). Seven items measure severity of depressive symptoms. Scores for depressive symptom severity range from 0 to 21 with higher scores indicating more severe depressive symptoms.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  7. Severity of Somatic Hyperarousal Symptoms

    Hyperarousal symptoms will be measured using the 16-item Pre-Sleep Arousal Scale (PSAS). Eight items measure severity of somatic hyperarousal symptoms. Scores for somatic hyperarousal symptom severity range from 8 to 40 with higher scores indicating worse somatic hyperarousal severity.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  8. Severity of Cognitive Hyperarousal Symptoms

    Hyperarousal symptoms will be measured using the 16-item Pre-Sleep Arousal Scale (PSAS). Eight items measure severity of cognitive hyperarousal symptoms. Scores for cognitive hyperarousal symptom severity range from 8 to 40 with higher scores indicating worse cognitive hyperarousal severity.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  9. Mindfulness Skills as Measured by the Kentucky Inventory of Mindfulness Skills (KIMS): Observing

    Mindfulness skills (i.e., observing, describing, acting with awareness, and accepting/non-judgement) will be measured using the 39-item Kentucky Inventory of Mindfulness Skills (KIMS). Observing (range: 12-60) is measured by 12 items. Higher scores indicate higher levels of observing skills.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  10. Mindfulness Skills as Measured by the Kentucky Inventory of Mindfulness Skills (KIMS): Describing

    Mindfulness skills (i.e., observing, describing, acting with awareness, and accepting/non-judgement) will be measured using the 39-item Kentucky Inventory of Mindfulness Skills (KIMS). Describing (range: 8-40) is measured by eight items. Higher scores indicate higher levels of describing skills.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  11. Mindfulness Skills as Measured by the Kentucky Inventory of Mindfulness Skills (KIMS): Acting With Awareness

    Mindfulness skills (i.e., observing, describing, acting with awareness, and accepting/non-judgement) will be measured using the 39-item Kentucky Inventory of Mindfulness Skills (KIMS). Acting with awareness (range: 10-50) is measured by ten items. Higher scores indicate higher levels of acting with awareness skills.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  12. Mindfulness Skills as Measured by the Kentucky Inventory of Mindfulness Skills (KIMS): Accepting/Non-judgement

    Mindfulness skills (i.e., observing, describing, acting with awareness, and accepting/non-judgement) will be measured using the 39-item Kentucky Inventory of Mindfulness Skills (KIMS). Accepting is measured by nine items (range: 9-45). Higher scores indicate higher levels of accepting skills.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

  13. Self-efficacy for Symptom Management as Measured by the Self-Efficacy for Management Chronic Disease Scale (SEMCD)

    SEMCD scores range from 0 to 10 with higher scores indicating greater self-efficacy for symptom management.

    Measured: 0 weeks, 12 weeks, 16 weeks (baseline, post-intervention, 4-weeks post-intervention)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Feb 2021
  2. Study start1 Apr 2021
  3. Primary completion19 May 2023
  4. Study completion19 May 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Single Group Assignment
Masking
None (open label)
Enrolment
57 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04736056
Sponsor's protocol ID
Pro00107338
Status last verified
Oct 2024
First submitted
29 Jan 2021
Last updated
2 Dec 2024
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Fisher HM, Hyland KA, Miller SN, Amaden GH, Diachina A, Ulmer CS, Danforth M, LeBlanc TW, Somers TJ, Keefe FJ. Mindful Night-to-Day: A Pilot Feasibility Trial of a Mindfulness-Based Insomnia and Symptom Management Intervention for Patients with Hematologic Cancer. Behav Sleep Med. 2024 Sep-Oct;22(5):674-696. doi: 10.1080/15402002.2024.2339819. Epub 2024 Apr 10.

    PubMed 38597262

Questions about this trial

What is this clinical trial studying?

A study testing Mindfulness-Based Therapy for Insomnia with Cognitive-Behavioral Symptom Coping Skills in people with Hematologic Malignancy, run by Duke University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Dec 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility as Measured by Number of Participants Accrued to Single-arm Pilot (time frame: 12 weeks (post-intervention)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04736056, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Dec 2024.

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