ASPO Abstracts
Clinically relevant improvements in quality of life and fatigue following an exercise program for cancer survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose: This study utilized data from an existing cancer-exercise program to determine the proportion of participants who achieved minimal clinically important differences (MCID) for quality of life (QOL) and fatigue and explored determinants of achieving MCID. Methods: QOL and fatigue were assessed pre/post the 3-month exercise program. QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G; range 0-108) and fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue; range: 0-52). Higher scores reflect better QOL and less fatigue. MCIDs are a change of 5-points for the FACT-G and 3 points for the FACIT-Fatigue. The proportion achieving MCID was calculated, and independent t- tests and chi-square tests explored differences in age, body mass index (BMI), cancer treatment status, exercise session attendance and baseline QOL/fatigue value between those who did vs. did not achieve MCID. Significant variables were included in binomial logistic regression models. Results: Participants (N=236) were M=54±14.0 years old, majority female (67.8%), white (84.3%), with breast cancer (35.6%). QOL improved (MΔ=6.3±10.8), and 55.2% achieved MCID. Fatigue improved (MΔ=5.4±9.9), and 58.7% achieved the MCID. Regression models for QOL [B=4.13, SE=1.29, Wald=11.05, p=.001] and fatigue [B=2.29, SE=.907, Wald=6.39, p=.011] were significant. For QOL, higher age [Exp(β)=.972, CI=.948-.996] and baseline FACT-G score [Exp(β)=.945, CI=.921-.969] decreased the likelihood of achieving MCID, and attending more exercise sessions increased likelihood of achieving MCID [Exp(β)=1.12, CI=.1.04 – 1.96]. For fatigue, having completed treatment [Exp(β)=2.82, CI=1.41-5.63] and attending more exercise sessions [Exp(β)=1.13, CI=.1.04 – 1.21] increased likelihood of achieving MCID, and higher baseline FACIT-fatigue score decreased likelihood of achieving MCID [Exp(β)=.876, CI=.841-.914]. Conclusions: Starting an exercise program with worse QOL or fatigue, and greater exercise session adherence may increase the likelihood of deriving clinically relevant benefits in these outcomes. In addition, younger age and being finished with active treatment may increase the likelihood of achieving MCID in QOL and fatigue, respectively.
Keywords: survivorship; exercise