Measuring and understanding adherence in a home-based exercise intervention during chemotherapy for early breast cancer

Nyrop, Kirsten A.; Deal, Allison M.; Choi, Seul Ki; Wagoner, Chad W.; Lee, J. T.; Wood, A. Jamie; Anders, Carey K.; Carey, Lisa A.; Dees, Elizabeth Claire; Jolly, Trevor A.; Reeder-Hayes, K E; Muss, Hyman B.

doi:10.1007/s10549-017-4565-1

Cited by 51 publications

(48 citation statements)

References 58 publications

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“…Our analyses should be interpreted as exploratory, since the study was not primarily powered for the current study; consequently, additional predictors might have been missed. In other studies, exercise facility location [20], fewer endocrine symptoms [13], lower durations of exercise [13], fewer exercise limitations [13], shorter chemotherapy protocol [13], exercise history [19], being employed[18, 21], high income [21], early stage disease [18] and being Caucasian [22] were found as predictors for adherence, while these predictors were not assessed in this study. In univariate analyses, several predictors were found to be significant but were not supported in the multivariable analysis, which might have been the result of multicollinearity or restricted statistical power.…”

Section: Discussionmentioning

confidence: 77%

“…Patients who perceived a higher importance of exercise, who had an early stage of disease, and who were employed had a higher compliance with exercise intensity [18]. The study of Nyrop et al reported that being Caucasian or reporting higher walking minutes prior to the start of chemotherapy was associated with greater walking steps per week in a home-based exercise intervention [22]. To our knowledge, no studies were performed reporting predictors about compliance in supervised exercise programs during treatment in breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

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Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study

et al. 2019

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Purpose Maintaining high adherence rates (session attendance and compliance) in exercise programs during breast cancer treatment can be challenging. We aimed to identify adherence rates and predictors to an exercise program during adjuvant breast cancer treatment. Methods Ninety-two patients with localized breast cancer undergoing chemotherapy were randomly assigned to an 18-week supervised moderate-to-high intensity aerobic and resistance exercise program, including two 1-hour sessions/week. Additionally, participants were asked to be physically active for at least 30 minutes/day on at least three other days. We report median percentages for attendance, compliance with the prescribed duration and intensity of aerobic and muscle strength exercises, and the exercise advice given. Predictors included in univariate and multivariable linear regression models were demographical, tumor- and treatment-related factors, constructs of the theory of planned behavior, psychological and physical factors. Results Patients attended 83% (interquartile range: 69–91%) of the supervised sessions. Compliance with the duration of aerobic exercise, high-intensity aerobic exercise (cycling at the ventilatory threshold), muscle strength exercises and the exercise advice were 88%(64–97%), 50%(22–82%), 84%(65–94%) and 61%(33%–79%), respectively. Education, radiotherapy, BMI and physical fatigue were important predictors of adherence to supervised exercise. Beliefs about planned behaviors were important predictors, especially for compliance with the exercise advice. Conclusions Attendance to and compliance with an 18-week aerobic and strength exercise program were high. The lowest compliance was found for high-intensity supervised aerobic exercise. The identified predictors should be considered when designing or adapting exercise programs for patients with localized breast cancer to increase adherence. Trial registration Current Controlled Trials ISRCTN43801571 Dutch Trial Register NTR2138

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study

et al. 2019

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“…There are a few examples in which the use of technology can support virtual cancer exercise and cancer rehabilitation systems, but they need further testing for feasibility, usability, acceptability, and implementation for a variety of populations. 46,47 Telehealth care is one type of delivery that needs further testing but recently was found to improve function, decrease pain, and decrease health care service use, 37 aiding community clinicians and increasing the reach of cancer rehabilitation in rural and/or low-resource settings. 48 The use of technology also can revolutionize the evaluation of value metric reporting, and by adding real-time assessment of outcomes and quality.…”

Section: ) Improve Evidence Regarding Drivers Of Variations In Care mentioning

confidence: 99%

A health services research agenda to fully integrate cancer rehabilitation into oncology care

Pergolotti

Alfano

Cernich

et al. 2019

Cancer

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Adults with cancer are at risk of restricted functioning in work, usual activities, life roles, and quality of life both during and after cancer treatment. Herein, the authors discuss unique opportunities to examine how cancer rehabilitation, delivered as part of cancer and survivorship care, might help to achieve the quadruple aim of better patient health, better patient experience, and lower cost for patients who receive services, as well as improving the work life of clinicians and staff.

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“…Symptom experience may have been moderated in women who engaged in walking during chemotherapy compared with those who did not engage in walking. We previously reported that engaging in moderate walking during chemotherapy is very challenging, even among women aged <65 years who were enrolled in our intervention studies 29 …”

Section: Discussionmentioning

confidence: 99%

Patient‐reported symptom severity, interference with daily activities, and adverse events in older and younger women receiving chemotherapy for early breast cancer

Nyrop

Deal

Chen

et al. 2020

Cancer

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Background To the authors' knowledge, it is unknown whether patient‐reported symptom severity and symptom interference with daily activities differ between younger (aged <65 years) and older (aged ≥65 years) women receiving similar chemotherapy regimens for early breast cancer (EBC). Methods Study participants rated 17 side effects of chemotherapy regimens currently in use in clinical practice (2014‐2019). Results Of 284 women with EBC (stage I‐III), approximately 57% were aged <65 years and 43% were aged ≥65 years. For anthracycline‐based regimens, a higher percentage of younger women reported moderate, severe, or very severe (MSVS) hot flashes (49% vs 18%) (P < .001). For nonanthracycline regimens, a higher percentage of younger women reported MSVS hot flashes (38% vs 19%) (P = .009) and a lower percentage reported MSVS arthralgia (28% vs 49%) (P = .005). With regard to symptom interference with daily activities, a higher percentage of younger women being treated with anthracycline‐based regimens reported MSVS hot flashes (32% vs 7%) (P = .001) and myalgia (38% vs 18%) (P = .02). For nonanthracycline chemotherapy, a higher percentage of younger women reported MSVS interference for hot flashes (26% vs 9%) (P = .006) and lower percentages reported abdominal pain (13% vs 28%) (P = .02). Overall, there were no significant differences noted among younger versus older patients with regard to hospitalizations (19% vs 12%; P = .19), dose reductions (34% vs 31%; P = .50), dose delays (22% vs 25%; P = .59), or early treatment discontinuation (16% vs 16%; P = .9546). Conclusions Older and younger women with EBC who were treated with identical chemotherapy regimens generally experienced similar levels of symptom severity, symptom‐related interference with daily activities, and adverse events. Lay Summary In this study, women receiving chemotherapy for early breast cancer rated the severity of 17 symptoms and symptom interference with their activities of daily living. Older (aged ≥65 years) and younger (aged <65 years) women who received identical chemotherapy regimens generally experienced similar levels of symptom severity, symptom‐related interference with daily activities, and adverse events.

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Measuring and understanding adherence in a home-based exercise intervention during chemotherapy for early breast cancer

Cited by 51 publications

References 58 publications

Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study

Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study

A health services research agenda to fully integrate cancer rehabilitation into oncology care

Patient‐reported symptom severity, interference with daily activities, and adverse events in older and younger women receiving chemotherapy for early breast cancer

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