Project 461311

Brain metastases refer to when cancer cells spread from another place in the body to the brain. They are the most common brain cancer in adults and occur in roughly 30% of patients whose cancer does not originate in the brain. Many brain metastasis patients experience cognitive impairment to some extent, including problems with memory, communication, and multitasking that can impact symptom management, post-treatment recovery, emotional wellbeing and quality of life. Cognitive screening, assessment and management are needed to help these patients, but are largely unavailable. Health care providers in oncology clinics are well-positioned to screen for and support patient self-management of mild cognitive symptoms, but there is no system in place to support them doing so. Establishing a system that triages patients based on cognitive symptom severity may facilitate access to appropriate intervention. In this project, we will develop and evaluate a program to screen, assess, and manage cognitive symptoms in brain metastasis patients. In Phase 1 of this project, we will codesign a program with patients, family representatives and interdisciplinary health care providers. The program will screen for cognitive symptoms during outpatient clinics and triage screen-positive patients to online cognitive assessment, psychoeducational counselling, and/or neuropsychologist referral. During Phase 2, we will evaluate the acceptability, feasibility, and preliminary efficacy of this program in the brain metastases clinic. Data collection will include patient, family, and staff surveys and interviews, and administrative data to understand program impacts, and barriers and facilitators to program sustainability. Finally in Phase 3, our codesign team will review all the findings to make recommendations for the refinement, implementation, and further evaluation of this service.