Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Assessing the feasibility and tolerability of bright light therapy for the prevention of delirium in hospitalised adults with advanced cancer: protocol for a pilot RCT (145121)

LAYLA M EDWARDS 1 , Rayan Saleh Moussa 1 , Annmarie Hosie 1 2 , Joshua Wiley 3 , Irina Kinchin 4 , Vanessa Yenson 1 , Imelda Gilmore 1 , Gideon A. Caplan 5 6 , Angela A. Rao-Newton 1 , Ingrid Amgarth-Duff 7 , Sungwon Chang 1 , Kimberley Campbell 1 , Kim Offner 1 , Meera Agar 1 8
  1. IMPACCT, Faculty of Health, University of Technology Sydney, Ulitmo, NSW, Australia
  2. University of Notre Dame, Chippendale, NSW, Australia
  3. Monash University, Melbourne, Victoria, Australia
  4. Trinity Colledge Dublin, Dublin, Ireland
  5. University of New South Wales, Sydney, NSW, Australia
  6. Prince of Wales Hospital, Sydney, NSW, Australia
  7. Telethon Kids Institute, Perth, Western Australia, Australia
  8. South West Sydney Local Health District, Sydney, NSW, Australia

Background and aim:

Delirium affects up to two-thirds of hospitalised adults with advanced cancer and is associated with prolonged hospitalisation, functional and cognitive decline, and increased mortality (1, 2). Existing multicomponent delirium prevention programs often rely on physical and cognitive activities that are often difficult for people with advanced cancer because of fatigue and frailty (3). Sleep disturbance and circadian rhythm disruption are modifiable risk factors for delirium (4). Bright light therapy (BLT) is a non-pharmacological intervention that may support circadian rhythm alignment and improve sleep, but its feasibility in advanced cancer populations remains unknown (5). The aim of this study is to determine whether BLT is feasible and tolerable for the prevention of delirium in hospitalised adults with advanced cancer.

Methods:

This multi-site, open-label pilot randomised controlled trial will recruit 56 adults with advanced cancer admitted to oncology and palliative care units within public hospitals in Australia. Participants will be randomised (1:1) within 48 hours of hospital admission to receive either standard supportive care alone or standard supportive care plus BLT, delivered via the Re-Timer™ device. Intervention arm participants will receive 60 minutes of BLT each morning for seven consecutive days, in line with therapeutic recommendations (6,7). Primary outcome is feasibility, measured by intervention completion and treatment adherence. Secondary outcomes include BLT tolerability, delirium (incidence and severity), changes in sleep and melatonin levels, quality of life, and resource utilization, captured daily. Recruitment has commenced.

Discussion:

This study will provide the first evidence regarding the feasibility and tolerability of BLT for delirium prevention in hospitalised adults with advanced cancer. Findings will inform the design and implementation requirements of a future phase III trial evaluating the efficacy of BLT for preventing delirium in this high-risk population.

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