Telehealth weight loss program for breast cancer survivors is feasible and acceptable: Preliminary results of pilot clinical trial.

Abstract

TPS1603 Background: Current weight loss programs for breast cancer survivors utilize a hybrid of in-person visits or individualized telephone-based sessions modeled after the Diabetes Prevention Program. Telehealth may be an effective and efficient means of communicating with patients who otherwise cannot participate in in-person visits. To test this concept, we conducted a pilot single-arm study (NCT04855552) to examine the feasibility and acceptability of a weight loss group program via telehealth for breast cancer survivors. Methods: Patients > = 18 years with ECOG performance 0 or 1, a BMI of ³ 25 kg/m2, and completion of adjuvant radio- and/or chemo-therapy > 6 months were eligible. Patients attended weekly zoom teleconference counseling grouped sessions either at noon or 5 pm led by a licensed clinical psychologist for 20 weeks followed by sessions in weeks 22 and 24. Patients were encouraged to use MyFitnessPal.com, an online tool, to monitor calorie intake and physical activity and digital scales to monitor weight to share with study staff to enhance accountability and provide opportunity for feedback. Feasibility was defined as a ratio of enrolled/eligible patients ≥50%. Acceptability was assessed from surveys pre- and post-treatment, and qualitatively from exit interviews. Secondary endpoints included changes in Quality of Life-Breast Cancer Patient (QOF-BC), Patient Health Questionnaire (PHQ-9), and percent weight loss from baseline to 24 weeks. Results: Clinical characteristics of patients are summarized in Table. The ratio of enrolled (n = 12)/eligible (n = 23) participants was 52% thus confirming study feasibility. One patient dropped out after 2 sessions. Qualitative results from exit interviews showed that 7/9 patients rated the telehealth format as “extremely acceptable”. Surveys also indicated that the format and delivery of the program remained acceptable across most domains with no significant changes, except an increase in “approval” from 4.1 to 4.7 ( p= 0.05). Patients’ mood improved on the PHQ-9 from 4.2 to 1.2 (p = 0.03), and QOL-Physical Wellbeing improved from 56.9 to 66.3 (p = 0.004). Overall, 199 of 236 participant-sessions (84%) were attended. Percent weight loss was 6.5% +/- 2.5%. Conclusion: This proof-of-concept weight loss program was feasible and acceptable for our patients yielding improvements in QOL, mood, and a clinically significant weight loss over 6-months. This group-based video approach represents an intervention strategy that could be widely-disseminated and may provide stronger accountability/support than a one-on-one approach in some patients. Future work is aimed at refining strategies to increase patient enrollment/retention. Clinical trial information: NCT04855552. [Table: see text]