ASPO Abstracts
Predictors of Adherence in a Personalized Lung Cancer Exercise Trial: Results from the PEP Study
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2023
Abstract Body:
Purpose: Exercise interventions have shown benefits for physical function in lung cancer patients undergoing surgery. In this study, predictors of adherence to a pre-/post-surgery home-based, pragmatic, and personalized exercise intervention in lung cancer patients were assessed. Methods: Patients enrolled in the Precision Exercise Prescription (PEP) Trial and randomized to exercise were included in the analyses. The exercise group participated in a structured, clinic-schedule-aligned, remotely-administered intervention, tailored based on patients' mobility scores (AM-PAC). Weekly Motivation And Problem-Solving (MAPS) calls were conducted for motivational purposes and to discuss barriers, exercise modifications, and self-reported exercise adherence with participants. Notes from MAPS calls were used to classify patients as non- or partially adherent vs fully adherent (exercising >3 days/week) to the intervention from 2 months post-surgery to 5 months. The median adherence score across MAPS calls was utilized. Predictors of adherence at baseline were: clinicodemographic characteristics, 6-minute walk distance (6MWD), AM-PAC scores, and fatigue (FACIT-F). We used descriptive statistics and logistic regression analysis. Results: N=92 patients in the exercise group were assessed. Of those, 72 completed at least one MAPS call during from two months post-surgery to five months. N=23 patients were fully adherent (67+10 years, 28+4.8 kg/m2, 61% female), and N=49 (68%) patients were non-/partially-adherent (62+14 years, 29+5.9 kg/m2, 51% female). Fully adherent patients had a greater baseline 6MWD (511+102m vs. 445+136m), lower baseline fatigue (40+7 vs. 35+10), and fewer secondary cancer diagnoses (9% vs. 29%) relative to non/partially-adherent patients, and were more likely to live in rural communities. Adjusting for age and sex, baseline fatigue [OR1pt:1.07(95%CI:1.01-1.14), p=0.03] and baseline 6MWD [OR1m:1.01(95%CI:1.00-1.01), p=0.01] were statistically significant predictors of adherence. Conclusions: Adherence to the PEP Study intervention was greater among older, female, and primary lung cancer patients, those living in rural communities, and with lower fatigue, and higher 6MWD at baseline.
Keywords: Exercise Adherence Lung cancer