Development and Evaluation of a Multimodal Supportive Intervention for Promoting Physical Function in Older Patients with Cancer

SIMPLE SUMMARY: Physical function is important for older people to maintain selfcare and independence. Physical function may decline during oncologic therapy. In this study, a program to help maintain physical function was developed and tested. Cancer patients, 60 years and older, starting outpatient radiotherapy participated. The individual health condition, risk factors and quality of life were assessed. The results informed individual exercise plans and dietary recommendations. Participants received either paper-based or video-based instructions. After 12 weeks of intervention the assessments were repeated. Four weeks later, a questionnaire was sent to ask about physical activity, nutrition and quality of life. Twenty-four patients participated (14 women, 10 men) with a mean age of 70 ± 7 years. The majority rated the program as helpful. Paper-based or video-based instructions were appreciated equally. The intervention was feasible and showed potential benefit for the maintenance of physical function during outpatient radiotherapy and should be tested with a larger sample. ABSTRACT: Physical function (PF) in older patients with cancer may decline during and after oncologic therapy. This study aimed to develop and pilot test an individually tailored unsupervised physical activity (PA) program and dietary recommendations to promote PF in older patients with cancer. Following development and pretest, the intervention was pilot tested to explore feasibility, acceptance, adherence and potential benefit. Patients ≥60 years, with heterogeneous cancer diagnoses, starting outpatient radiotherapy were randomized in two study arms: paper-based vs. video-based instructions. Based on assessments of PF, PA, nutrition, cognition, mental health, social support, HRQOL and personal goals, participants received individual recommendations for PA and nutrition. After 12 weeks of intervention (T1), reassessments were performed. The postal 4-week follow-up questionnaire included PA, nutrition and HRQOL. Participants (n = 24, 14 female, mean age 70 ± 7 years) showed comparable characteristics in both study arms. The majority rated the program as helpful. Facilitators and barriers to PA adherence were collected. Both modes of instructions were appreciated equally. PF (EORTC QLQ-C30) declined slightly (not clinically relevant >10 pts.) at group level T0: 76 ± 16, T1: 68 ± 21, T2: 69 ± 24. The intervention was feasible, well accepted, showing potential benefit for the maintenance of PF during outpatient radiotherapy, and should be further tested in a larger sample.