Cost-Savings Analysis of an Individualized Exercise Oncology Program in Early-Stage Breast Cancer Survivors: A Randomized Clinical Control Trial

Abstract

PURPOSE: In an attempt to promote the integration of exercise oncology as a standard part of clinical practice, economic evaluations are warranted. Thus, the purpose of this study was to prospectively analyze cost savings of an individualized exercise oncology program when patients were randomly assigned. METHODS: For this open-label, randomized, prospective, comparative clinical trial, patients with early-stage breast cancer (stage I-II) were randomly assigned into two groups: the control group (CG, n = 120) and the exercise training group (EX, n = 123). Patients in the exercise intervention group completed 12 weeks of prescribed, individualized exercise that aligned with ACSM exercise guidelines for cancer survivors. The CG received the current standard of care, which includes a resource guide with various options available to the cancer survivor. RESULTS: In the EX group, all physical fitness measures significantly improved compared with baseline ( P < .001), while remaining unchanged for the CG ( P > .05). Patients in the CG had the highest total mean health care utilization across all measures (CG: $8,598 US dollars, compared with EX: $6,356 US dollars) for emergency visits, outpatient visits, and office-base visits that were not a part of their treatment plan. At baseline, the mean Eastern Cooperative Oncology Group (ECOG) scores did not significantly differ ( P > .05); however, at follow-up, a larger proportion of the EX group had ECOG scores of 0 or 1, compared with the CG ( P < .05). Finally, patient-reported outcomes were significantly higher in the exercise group, compared with the CG at the 12-week follow-up ( P < .001). CONCLUSION: A supervised, individualized 12-week exercise intervention led to significant improvements in fitness parameters and ECOG scores, as well as a decrease in unplanned health care utilization among early-stage breast cancer survivors.

Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review

“…From an institutional and physician perspective, major barriers for service integration are related to limited funding, lack of a detailed implementation plan, limited availability of suitable programmes, and low organizational buy-in (lack of public funding and resources). In addition, the physicians’ characteristics of lacking exercise science educational backgrounds, related knowledge, and specific professional qualifications have also been noted as detrimental ( 24 , 32 , 44 , 51 , 58 ). Furthermore, in real work situations the lack of time for counselling, workload pressures, and extra work concerns, would all disrupt clinic efficiency and have been identified as related issues contributing to barriers for providing exercise prescription to patients ( 58 ).…”

“…Another example is the implementation of tailored exercise interventions for women following breast cancer diagnosis in Brisbane, Australia. A supervised exercise intervention led to significant improvements in fitness parameters and significant decreases in breast cancer health care utilization ( 32 ) This provided a cost-effective treatment compared to usual care with eight-year follow-up ( 59 ).…”

Differential Impact of Exercises on Quality-of-Life Improvement in Breast Cancer Survivors: A Network Meta-Analysis of Randomized Controlled Trials

“…After removing duplicate articles and excluding non-relevant articles by screening titles and abstracts, we ultimately included nine randomized controlled trials [ 6 , 8 , 9 , 10 , 11 , 43 , 44 , 45 , 46 ]. The articles excluded in the final stage [ 4 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ,…”

Cardiovascular Health Metrics Differ Between Individuals With and Without Cancer

“…We identify a significant role of race, ethnicity, and SES status on health factors and behaviors in individuals with cancer, including those that have been associated with improved quality of life and outcomes, as well as potentially reduced costs, after a cancer diagnosis. 26 , 27 , 28 Among all races, ethnicities, and SES statuses, individuals with cancer had lower health factors compared with those without cancer.…”