Predictors and moderators of outcomes in mindfulness-based cognitive therapy intervention for early breast cancer patients

Noriko Tamura; Sunre Park; Yasunori Sato; Yasuko Sato; Yuka Takita; Akira Ninomiya; Mitsuhiro Sado; Masaru Mimura; Daisuke Fujisawa

doi:10.1017/S147895152100078X

Predictors and moderators of outcomes in mindfulness-based cognitive therapy intervention for early breast cancer patients

Palliat Support Care. 2022 Apr;20(2):159-166. doi: 10.1017/S147895152100078X.

Authors

Noriko Tamura¹, Sunre Park², Yasunori Sato³, Yasuko Sato⁴, Yuka Takita⁵, Akira Ninomiya^{1

6}, Mitsuhiro Sado^{1

6}, Masaru Mimura¹, Daisuke Fujisawa^{1

7}

Affiliations

¹ Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
² Faculty of Nursing and Medicine Care, Keio University, Shinjuku-ku, Tokyo, Japan.
³ Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan.
⁴ Department of Nursing, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
⁵ Faculty of Health Sciences, Tokyo Kasei University, Itabashi-ku, Tokyo, Japan.
⁶ Center for Stress Research, Keio University, Shinjuku-ku, Tokyo, Japan.
⁷ Division of Patient Safety, Keio University Hospital, Shinjuku-ku, Tokyo, Japan.

PMID: 34158140
DOI: 10.1017/S147895152100078X

Abstract

Objectives: To deliver mindfulness-based cognitive therapy (MBCT) efficiently, the present study aimed (1) to identify predictors and moderators of patients who benefit from MBCT for psychological distress and (2) to explore the initial treatment reaction to identify the optimal number of sessions that produce a significant clinical effect.

Methods: This is the secondary analysis of a randomized controlled trial of MBCT for breast cancer patients (N = 74). We classified the participants into remitters vs. non-remitters, and responder vs. non-responders, according to the total score of the Hospital Anxiety and Depression Scale at the end of the intervention. We conducted multivariate analyses to explore for predictors of response and remission. We adopted generalized estimating equations to explore the optimal number of sessions.

Results: Sociodemographic and clinical backgrounds did not have significant influence on the treatment outcomes of the MBCT. Better program adherence, which was represented as the participants' better attendance to the MBCT program, was a significant predictor of both remission and response [odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.25-2.89, p = 0.003, and OR = 1.72, 95% CI 1.12-2.65, p = 0.013, respectively]. It was not until seventh session that the remission rate exceeded 50% and the response rate showed significance.

Significance of results: Sociodemographic and clinical characteristics did not significantly influence the treatment outcomes, while homework minutes and class attendance had significant effects on treatment outcomes. This implies that MBCT is recommended to any cancer patient, if he/she is motivated to the program, regardless of their sociodemographic and clinical characteristics. Patients are encouraged to attend a standard MBCT program (eight sessions) and do the assigned homework as intensely as possible. Further studies with larger sample and objective measurements are desired.

Keywords: Breast cancer; Mindfulness-based cognitive therapy; Moderator; Predictor; Treatment adherence.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Breast Neoplasms* / complications
Breast Neoplasms* / psychology
Breast Neoplasms* / therapy
Cognitive Behavioral Therapy*
Female
Humans
Mindfulness*
Psychological Distress*
Treatment Outcome