AN INTEGRATED LUNG CANCER SURVIVORSHIP PROGRAM IMPROVES ELEMENTS OF QUALITY OF LIFE IN LUNG CANCER SURVIVORS

Abstract

SESSION TITLE: Pulmonary Rehabilitation Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Dyspnea, poor functional status, and depression are common among lung cancer survivors. There are few recognized interventions to address these issues. We have developed an integrated lung cancer survivorship program (LCSP) to address symptoms of fatigue, dyspnea, and mental distress by enrolling patients in a 12 week long home-based pulmonary rehabilitation program as well as providing mental health assessment when indicated with appropriate referrals to mental health providers. Patients were assessed for quality of life and symptoms of anxiety and depression at enrollment and completion visits. METHODS: The Durham Veterans Administration Medical Center LCSP began enrolling patients in January 2019 and we report 12 months of data collection. Patients with a Karnofsky score ≥ 60 were invited to participate in home-based pulmonary rehabilitation with exercises 5 days a week (goal 1 hour per day). Quality of life was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) while symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Assessment tools were administered at program enrollment and completion. Veterans with a HADS > 8 were considered to be suffering from depression and were offered medical therapy and referral to a health care professional. Study and behavior health coordinators contacted enrollees weekly to assess progress, assist with difficulties in exercises, and assess symptoms of depression and fatigue. The duration of the intervention was 12 weeks. RESULTS: 42 patients were enrolled. Of these, 36 completed the surveys, 19 completed the 12-week intervention, and 10 were referred to mental-health providers. In patients who completed the 12-week intervention, there was a mean increase of 5.87 points in the FACT-L (n = 19, 95% CI: -0.208 – 12.0, p = 0.058), with significant increases in the emotional (1.47 point increase, p = 0.025) and lung (2.22 point increase, p = 0.023) subscales. There was a mean decrease of 2.53 points in the HADS (n = 15, 95% CI: -0.0461-5.11, p = 0.054), with a significant decrease in the anxiety subscale (2.00 point decrease, p = 0.020). There was a non-statistically significant trend toward worse quality of life and depression/anxiety scores at enrollment in patients who did not complete the intervention. CONCLUSIONS: We observed trends toward improvement in FACT-L and HADS scores and significant improvements were seen in some of their subscores after intervention with a 12-week Lung Cancer Survivorship Program. Home-based interventions are well accepted among veterans with lung cancer, and completion rates were similar to those described in other exercise-based intervention programs. CLINICAL IMPLICATIONS: A home-based lung cancer survivorship program can provide clinically significant improvements for lung cancer survivors. DISCLOSURES: No relevant relationships by Alisa Hassinger, source=Admin input No relevant relationships by Brian Rabe, source=Admin input No relevant relationships by Scott Shofer, source=Web Response No relevant relationships by Jordan Stafford, source=Web Response No relevant relationships by H. Swartzwelder, source=Web Response