Community pharmacy lifestyle intervention to increase physical activity and improve cardiovascular health of men with prostate cancer: a phase II feasibility study

Abstract

ObjectivesTo assess the feasibility and acceptability of a community pharmacy lifestyle intervention to improve physical activity and cardiovascular health of men with prostate cancer. To refine the intervention.DesignPhase II feasibility study of a complex intervention.SettingNine community pharmacies in the UK.InterventionCommunity pharmacy teams were trained to deliver a health assessment including fitness, strength and anthropometric measures. A computer algorithm generated a personalised lifestyle prescription for a home-based programme accompanied by supporting resources. The health assessment was repeated 12 weeks later and support phone calls were provided at weeks 1 and 6.Participants116 men who completed treatment for prostate cancer.Outcome measuresThe feasibility and acceptability of the intervention and the delivery model were assessed by evaluating study processes (rate of participant recruitment, consent, retention and adverse events), by analysing delivery data and semi-structured interviews with participants and by focus groups with pharmacy teams. Physical activity (measured with accelerometry at baseline, 3 and 6 months) and patient reported outcomes (activation, dietary intake and quality of life) were evaluated. Change in physical activity was used to inform the sample size calculations for a future trial.ResultsOut of 403 invited men, 172 (43%) responded and 116 (29%) participated. Of these, 99 (85%) completed the intervention and 88 (76%) completed the 6-month follow-up (attrition 24%). Certain components of the intervention were feasible and acceptable (eg, community pharmacy delivery), while others were more challenging (eg, fitness assessment) and will be refined for future studies. By 3 months, moderate to vigorous physical activity increased on average by 34 min (95% CI 6 to 62, p=0.018), but this was not sustained over 6 months.ConclusionsThe community pharmacy intervention was feasible and acceptable. Results are encouraging and warrant a definitive trial to assess the effectiveness of the refined intervention.

Exercise Counselling To Promote Exercise Behaviour Change In Individuals With Prostate Cancer

“…51 This study highlights that while exercise counselling can be delivered as a unique intervention to cancer survivors, a more structured delivery protocol may be required within clinical settings. 51 Only two previous studies have evaluated the delivery of an exercise counselling intervention to prostate cancer survivors; a mixed methods study by Lemanska et al (2019) that included a multicomponent lifestyle intervention that incorporated an element of exercise counselling, and the 3-arm phase II RCT by Alibhai et al (2019) described above. 111,112,116 Lemanska et al (2019) used a community pharmacy team to deliver an intervention to 116 nonmetastatic prostate cancer survivors who had completed primary treatment, were inactive and who had a cardiometabolic risk factor.…”

“…51 Only two previous studies have evaluated the delivery of an exercise counselling intervention to prostate cancer survivors; a mixed methods study by Lemanska et al (2019) that included a multicomponent lifestyle intervention that incorporated an element of exercise counselling, and the 3-arm phase II RCT by Alibhai et al (2019) described above. 111,112,116 Lemanska et al (2019) used a community pharmacy team to deliver an intervention to 116 nonmetastatic prostate cancer survivors who had completed primary treatment, were inactive and who had a cardiometabolic risk factor. 116 At baseline and 3-months, in-person assessments were performed and included physical activity levels (self-report and objectively measured with accelerometers), anthropometric testing and a home support pack (educational DVD, booklet, pedometer, resistance bands) provided by the pharmacy team.…”

“…111,112,116 Lemanska et al (2019) used a community pharmacy team to deliver an intervention to 116 nonmetastatic prostate cancer survivors who had completed primary treatment, were inactive and who had a cardiometabolic risk factor. 116 At baseline and 3-months, in-person assessments were performed and included physical activity levels (self-report and objectively measured with accelerometers), anthropometric testing and a home support pack (educational DVD, booklet, pedometer, resistance bands) provided by the pharmacy team. 116 Pharmacists delivered two telephone support calls that included a lifestyle consultation at 1-week and 6-weeks.…”

“…116 At baseline and 3-months, in-person assessments were performed and included physical activity levels (self-report and objectively measured with accelerometers), anthropometric testing and a home support pack (educational DVD, booklet, pedometer, resistance bands) provided by the pharmacy team. 116 Pharmacists delivered two telephone support calls that included a lifestyle consultation at 1-week and 6-weeks. 116 Attendance was 85% at 3-months and 76% completed accelerometer evaluations at 3-and 6months.…”

“…116 Pharmacists delivered two telephone support calls that included a lifestyle consultation at 1-week and 6-weeks. 116 Attendance was 85% at 3-months and 76% completed accelerometer evaluations at 3-and 6months. 116 Significant improvements were seen in objectively measured MVPA of 34 mins/week (baseline 245+250 mins/week), but significance was not sustained at 6-months.…”