Women with a BRCA1/2 genetic mutation (mutation carriers) have a high risk for developing breast and ovarian cancer. Upon testing positive for a BRCA1/2 mutation, women face complex risk management and communication decisions, with many reporting increased distress levels. Peer support, may reduce this distress.
To test the effectiveness of telephone-based peer support in reducing distress among female BRCA1/2 mutation carriers using a randomised control trial (RCT).
337 women (response rate 42%) completed baseline surveys, with those interested in talking to other mutation carriers randomised to usual care (UCG) (n=102) or the intervention (n=105) (IG). IG women were matched to trained volunteers who contacted them multiple times over four-months to provide peer support. All volunteers were mutation carriers. Study participants completed follow-up questionnaires four months (Time 2) and six months (Time 3) after randomisation. Outcomes included breast cancer distress (primary outcome), unmet needs, BRCA1/2 related cognitive appraisals-stress and feelings of isolation. Multilevel linear regression models tested the effect of the intervention.
On average IG women received 3.7 peer calls (SD=2.1). Average call length decreased from 34 minutes (call 1) to 24 minutes (calls 3-6). There was a greater decrease in distress among IG than UCG at Time 2 (mean difference: -5.96, p=0.002) and Time 3 (mean difference: -3.94, p=0.04). There was a greater reduction in unmet needs among the IG than UCG (p<0.01) with IG unmet needs significantly lower than UCG needs at Time 2. The IG had a greater reduction in cognitive appraisals-stress than the UCG (p<0.01).
This is the first RCT to investigate the effect of peer support for BRCA1/2 mutation carriers. Our findings suggest that for mutation carriers interested in talking to similar women, peer support can reduce distress and unmet information needs. Further development of peer support programs for this group is warranted.