Oh, P.J., & Kim, J. 2016. The effects of nonpharmacologic interventions on cognitive function in patients with cancer: A meta-analysis. Oncology Nursing Forum, 43, E205–E217.
STUDY PURPOSE: To examine nonpharmacologic intervention effects on cognitive function in adult survivors of cancer, and to examine whether these effects are driven by psychological or behavioral intervention types
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Elder care
Eleven studies used psychological interventions, and three used behavioral interventions. All studies used standard care control groups, with intervention durations of two weeks to more than one year that included an average of 16 one-hour sessions. Psychological interventions used individual-based cognitive rehabilitation (n = 10) with three using computer-based retraining programs. Outcomes included subjective cognitive function (n = 5), attention (n = 6), memory (n = 8), executive function (n = 7), verbal ability (n = 3), and multiple domains (n = 7). Low risk bias assessments: Rrandomization (n = 5), allocation concealment (n = 3), blinded participants or personnel (n = 2), blinded personnel conducting outcome assessment (n = 4), attrition (n = 12), reporting bias (n = 14), monitoring procedures, and manual use (n = 13). Statistical heterogeneity ranged from none to moderate (I2 = 0%–68%). Significant treatment effects existed for nonpharmacologic interventions on memory (n = 8, d = 0.21, 95% confidence interval [CI] [0.04, 0.38], p = 0.02, I2 = 0%) and perceived cognitive function (n = 5, d = 0.41, 95% CI [0.2, 0.61], p < 0.001, I2 = 0%). Subgroup analysis for psychological interventions was significant for effect on perceived cognitive function (n = 3, d = 0.35, 95% CI [0.13, 0.58], p = 0.002, I2 = 0%).
The treatment effects of nonpharmacologic interventions significantly improved memory and perceived cognitive function. The meta-analysis indicated that psychological interventions significantly improved perceived cognitive function. No treatment effects from other interventions were observed, and no effects on cognitive performance in domains of executive function, attention, and verbal ability were observed. Most studies reviewed in this meta-analysis did not provide sufficient evidence to demonstrate improvement in cognitive performance. Further study is warranted using RCT designs to increase the sample pool to observe positive treatment effects.
Nonpharmacologic interventions, specifically those involving psychological interventions, have demonstrated improvements in memory and self-reported cognitive function in adult survivors of cancer.