Patient Preference Strategy Improves Exercise Adherence in Metastatic Cancer

Patients with metastatic cancer who chose the mode of delivery for exercise were more likely to adhere to an exercise program and experienced improved outcomes, according to a study in The Oncologist. 

Researchers seeking feasible strategies for encouraging patients with metastatic cancer to exercise recruited patients to a 3-month exercise program in which the patients could choose their preferred mode of delivery: a personal training program, a home-based program, or a group-based program. The primary endpoint was feasibility of exercise. 

Participants were able to choose whether they preferred to exercise at home, with a personal trainer, or in a group-based program. Of the 44 patients who were recruited, 28 chose the personal training program, 16 opted for the home-based program, and no one opted for the group-based program. 

Nine (20%) patients eventually dropped out: 6 in the personal training arm and 3 in the home-based arm.  

Feasibility was assessed by recruitment and completion rate, attendance, adherence to the program, and program tolerance. The median attendance rate was 92%. Additionally, the adherence rate was 88% and tolerability was 100%. 

The researchers found that exercise helped the patients improve their flexibility, cardiorespiratory fitness, and some aspects of their quality of life (QOL). Some domains of QOL associated with functioning also improved after the exercise intervention, including physical and emotional functioning, as well as symptoms such as fatigue and appetite loss. 

No noticeable differences were discerned between the patients in the home-based model compared with those in the personal training model. The researchers suggested that allowing the patients to choose their exercise modality may have given them an improved sense of empowerment.

The researchers concluded that a 12-week exercise program based on a patient preference model is both safe and feasible.

“Although the impact of exercise on QOL, and symptoms such as nausea and fatigue are well established, our findings may be particularly relevant, since most of the available studies analyzing the effect of exercise on QOL and symptoms are conducted in early-stage context,” they wrote. 

“Indeed, QOL assumes considerable importance in daily oncology practice, especially in the treatment pathway of patients with incurable disease, in which more consideration is oriented to the trade-off between patients’ quality and quantity of life, and the decision-making process is often oriented toward extending the patient’s life without reducing QOL.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.