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CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer.

Tsianakas, V, Harris, Jenny, Ream, Emma, Van Hemelrijck, M, Purushotham, A, Mucci, L, Green, JSA, Fewster, J and Armes, Jo (2017) CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer. BMJ Open, 7 (2), e013719.

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Abstract

Objectives: Walking is an adaptable, inexpensive and accessible form of physical activity. However its impact on quality of life and symptom severity in people with advanced cancer is unknown. This study aimed to assess the feasibility and acceptability of a randomised controlled trial (RCT) of a community-based walking intervention to enhance quality of life (QoL) in people with recurrent/metastatic cancer.

Design: We used a mixed-methods design comprising a two-centre RCT and nested qualitative interviews. Participants: Patients with advanced breast, prostate, gynaecological or haematological cancers randomised 1:1 between intervention and usual care.

Intervention: The intervention comprised Macmillan’s ‘Move More’ information, a short motivational interview with a recommendation to walk for at least 30 minutes on alternate days and attend a volunteer-led group walk weekly.

Outcomes: we assessed feasibility and acceptability of the intervention and RCT by evaluating study processes (rates of recruitment, consent, retention, adherence and adverse events), and using end of study questionnaires and qualitative interviews. Patient reported outcome measures (PROMS) assessing quality of life (QoL), activity, fatigue, mood and self-efficacy were completed at baseline and 6, 12 and 24 weeks.

Results: We recruited 42 (38%) of eligible participants. Recruitment was lower than anticipated (goal n=60), the most commonly reported reason being unable to commit to walking groups (n=19). Randomisation procedures worked well with groups evenly matched for age, sex and activity. By week 24, there was a 45% attrition rate. Most PROMs whilst acceptable were not sensitive to change and did not capture key benefits.

Conclusions: The intervention was acceptable, well tolerated and the study design was judged acceptable and feasible. Results are encouraging and demonstrate that exercise was popular and conveyed benefit to participants. Consequently, an effectiveness RCT is warranted, with some modifications to the intervention to include greater tailoring and more appropriate PROMs selected.

Item Type: Article
Subjects : Health Sciences
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Tsianakas, VUNSPECIFIEDUNSPECIFIED
Harris, Jennyjen.harris@surrey.ac.ukUNSPECIFIED
Ream, Emmae.ream@surrey.ac.ukUNSPECIFIED
Van Hemelrijck, MUNSPECIFIEDUNSPECIFIED
Purushotham, AUNSPECIFIEDUNSPECIFIED
Mucci, LUNSPECIFIEDUNSPECIFIED
Green, JSAUNSPECIFIEDUNSPECIFIED
Fewster, JUNSPECIFIEDUNSPECIFIED
Armes, Jojo.armes@surrey.ac.ukUNSPECIFIED
Date : 1 February 2017
Identification Number : 10.1136/bmjopen-2016-013719
Copyright Disclaimer : Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Additional Information : Trial registration number ISRCTN42072606.
Depositing User : Symplectic Elements
Date Deposited : 03 Jan 2017 17:29
Last Modified : 27 Oct 2017 13:45
URI: http://epubs.surrey.ac.uk/id/eprint/813189

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