Improve the management of cancer-related cognitive impairment in clinical settings: a European Delphi study

Abstract

Abstract Purpose Cancer-related cognitive impairment (CRCI) is under-addressed by healthcare professionals owing to a lack of clinical management guidelines. This European Delphi study aims to propose recommendations to healthcare professionals for the management of CRCI in patients with non-central nervous system (non-CNS) cancers. Methods The survey included European professionals (psychologists, physicians, researchers) who are experts in CRCI. Twenty-two recommendations were developed based on a literature review and authors’ clinical experience, split into three categories: screening, cognitive assessment, intervention. The Delphi method was used. Experts assessed the clinical relevancy of recommendations on a 9-point Likert scale in three rounds. A recommendation was accepted if all votes were between 7 and 9. Results Eighteen professionals voted and accepted 15 recommendations. Experts recommended the systematic screening of CRCI, followed by a short objective cognitive assessment, if complaints screened. A comprehensive evaluation is recommended if CRCI persists 6-months post-treatment. Cognitive rehabilitation, physical activity, meditative-movement therapy, and multimodal intervention should be offered. No consensus was reached for frequency and duration of interventions, the professional to administer cognitive rehabilitation and the use of meditation and cognitive training without psychoeducation. Conclusions This survey provides 15 recommendations to assist healthcare professionals in detecting, assessing and offering interventions for CRCI to patients with non-CNS cancers. Implications for Cancer Survivors These recommendations should be included in supportive care to help healthcare professionals to detect CRCI and thus to propose the best available intervention for patients with cognitive complaints. Developing CRCI management in clinical settings would improve patients’ quality of life.