E-poster Presentation 2014 World Cancer Congress

Can peer support program for female BRCA1 or BRCA2 mutation carriers reduce distress? Findings from a randomized controlled trial (#1120)

Victoria White 1 , Mary-Anne Young 2 , Ashley Farrelly 1 , Bettina Meiser 3 , Michael Jefford 4 , Sandra Ieropoli 5 , Jessica Duffy 6 , Elizabeth Williamson 7 , Ingrid Winship 8
  1. Cancer Council Victoria, Carlton, Vic, Australia
  2. Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. Psychosocial Research Group, The University of New South Wales, Sydney, NSW, Australia
  4. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  5. Early in Life Mental Health Service, Monash Health Mental Health Program, Melbourne, Victoria, Australia
  6. Hereditary Cancer Clinic, Prince of Wales Hospital,, Sydney, NSW, Australia
  7. School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  8. The Royal Melbourne Hospital, Melbourne, VIC, Australia

Background:

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. 

Aim:

To test the effectiveness of telephone-based peer support in reducing distress among female BRCA1/2  mutation carriers using a randomised control trial (RCT).

Methods:

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.

Results:

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).

Conclusions:

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.