The Feasibility of Web-Based Working Memory Training in Patients With Cancer Attending Inpatient Rehabilitation

Abstract

Introduction: Cognitive complaints are common late effects in patients with cancer, and no standard treatment exists. Recent studies with several patient populations have indicated that there is potential to improve working memory (WM) via web-based WM training. However, the feasibility of including web-based WM training as part of inpatient cancer rehabilitation, in combination with unprompted home-based training, has not been studied. The aim of this study was to assess the feasibility of including web-based WM training (using Cogmed QM) during inpatient rehabilitation and its subsequent unprompted completion in a home-based setting. Methods: Patients with cancer who self-reported cognitive complaints were instructed to complete 25 Cogmed QM sessions during their 3-week inpatient multidisciplinary cancer rehabilitation and subsequently at home after discharge from rehabilitation. The feasibility was determined by assessing the study recruitment, adherence to the WM training, improvements in training tasks (compliance measure) and patient experiences by individual interviews. Results: Twenty-nine (27 women) of 32 eligible patients (89.6%) started WM training, 1 declined participation and 2 patients withdrew before WM training started. Twenty-six of 29 (89.6%) participants adhered to the intervention during rehabilitation, while 19 of 29 (65.5%) also adhered to the subsequent unprompted home-based intervention. All participants who completed the Cogmed QM sessions demonstrated improvements in the training tasks, as defined by the Cogmed Improvement Index (MD = 24.05, SD = 9.38, range 2-44, P < .011). Interview data suggested that practical limitations, including a lack of time, technical difficulties, difficulties finding a suitable disturbance-free environment and low motivation were barriers to completing the training at home. Conclusion: The findings show that it is feasible to include web-based WM training during inpatient multidisciplinary rehabilitation for adult patients with cancer with cognitive complaints. However, patient adherence to unprompted web-based WM training after discharge from rehabilitation was not optimal. Thus, future studies should consider the barriers to adherence and the need for supervision and social support to reinforce home-based training.