Abstract
Background: Although facility-based cancer rehabilitation and exercise programs exist, patients are often unable to attend due to distance, cost, and other competing obligations. There is a need for scalable remote interventions that can reach and serve a larger population. Methods: We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Feasibility and acceptability data were captured by attendance and adherence metrics and through qualitative interviews. Preliminary estimates of the effects of CaRE@Home on patient-reported and physically measured outcomes were calculated. Results: A total of n = 35 participated in the study. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Acceptability was also high, and participants provided useful feedback for program improvements. Disability (WHODAS 2.0) scores significantly decreased from baseline (T1) to immediately post-intervention (T2) and three months post-intervention (T3) (p = 0.03 and p = 0.008). Physical activity (GSLTPAQ) levels significantly increased for both Total LSI (p = 0.007 and p = 0.0002) and moderate to strenuous LSI (p = 0.003 and p = 0.002) from baseline to T2 and T3. Work productivity (iPCQ) increased from T1 to T3 (p = 0.026). There was a significant increase in six minute walk distance from baseline to T2 and T3 (p < 0.001 and p = 0.010) and in grip strength from baseline to T2 and T3 (p = 0.003 and p < 0.001). Conclusions: Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required.
Highlights
Due to advances in early detection and biomedical treatment, over two-thirds of people who are diagnosed with invasive cancer will become long-term survivors [1,2]
We recently developed and implemented a virtual 8-week impairment-driven multidimensional Cancer Rehabilitation and Exercise program (CaRE@Home) with the aim to restore and optimize function and well being in those with identified cancer-related impairments
The CaRE@Home intervention was innovative in that it was impairment-driven and included: (1) individualized progressive exercise prescription supported with a mobile application and wearable technology; (2) weekly e-modules providing interactive education to promote self-management skills; (3) weekly brief telephone health coaching with a member of the rehabilitation team; and (4) was informed by behavior change theory
Summary
Due to advances in early detection and biomedical treatment, over two-thirds of people who are diagnosed with invasive cancer will become long-term survivors [1,2]. Cancer rehabilitation is an essential component of survivorship care and has become increasingly relevant as the number of cancer survivors grows, coupled with the high documented rates of physical impairment and disability [9,10,11,12]. For patients with complex rehabilitation needs, a personalized, coordinated multidisciplinary approach is required to decrease disability and achieve improvements in physical functioning and overall QoL. Methods: We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Conclusions: Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required
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