Association of Outpatient Cancer Rehabilitation With Patient-Reported Outcomes and Performance-Based Measures of Function

Introduction. Fatigue is a distressing symptom for adults with acute leukemia, often impeding their ability to exercise. Objectives. 1) Examine effects of a 4-week mixed-modality supervised exercise program (4 times a week, twice a day) on fatigue in adults with acute leukemia undergoing induction chemotherapy. 2) Evaluate effects of exercise program on cognition, anxiety, depression, and sleep disturbance. 3) Evaluate effect of intervention on adherence to exercise. Methods. 17 adults (8 intervention, 9 control), aged 28-69 years, newly diagnosed with acute leukemia were recruited within 4 days of admission for induction treatment. Patient-reported outcomes (PROs) (fatigue, cognition, anxiety, depression, sleep disturbance, mental health, and physical health) and fitness performance-based measures (Timed Up and Go [TUG], Karnofsky Performance Status, and composite strength scoring) were assessed at baseline and at discharge. Changes in PRO and performance-based physical function measures from baseline to time of discharge were compared between groups using Wilcoxon Rank Sum tests. Results. With PROMIS (Patient-Reported Outcomes Measurement Information System) Fatigue, we found a median change in fatigue (−5.95) for the intervention group, which achieved a minimally important difference that is considered clinically relevant. Intervention group reduced their TUG performance by 1.73 seconds, whereas the control group remained fairly stable. A concerning finding was that cognition decreased for both groups during their hospitalization. 80% adherence of visits completed with a mean of 6 sessions attended per week. Conclusions. Our study provides information on the impact of exercise on symptomatology, with focus on fatigue and other psychosocial variables in acute leukemia.

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Clinical Outcome Assessment in Cancer Rehabilitation and the Central Role of Patient-Reported Outcomes

Cancers ◽

10.3390/cancers14010084 ◽

2021 ◽

Vol 14 (1) ◽

pp. 84

Author(s):

Jens Lehmann ◽

Maria Rothmund ◽

David Riedl ◽

Gerhard Rumpold ◽

Vincent Grote ◽

...

Keyword(s):

Clinical Outcome ◽

Patient Reported Outcomes ◽

Health Condition ◽

Performance Outcomes ◽

Cancer Rehabilitation ◽

Third Party ◽

Special Focus ◽

Patient Reported ◽

Value Based Care ◽

Clinical Outcome Assessments

The aim of cancer rehabilitation is to help patients regain functioning and social participation. In order to evaluate and optimize rehabilitation, it is important to measure its outcomes in a structured way. In this article, we review the different types of clinical outcome assessments (COAs), including Clinician-Reported Outcomes (ClinROs), Observer-Reported Outcomes (ObsROs), Performance Outcomes (PerfOs), and Patient-Reported Outcomes (PROs). A special focus is placed on PROs, which are commonly defined as any direct report from the patient about their health condition without any interpretation by a third party. We provide a narrative review of available PRO measures (PROMs) for relevant outcomes, discuss the current state of PRO implementation in cancer rehabilitation, and highlight trends that use PROs to benchmark value-based care. Furthermore, we provide examples of PRO usage, highlight the benefits of electronic PRO (ePRO) collection, and offer advice on how to select, implement, and integrate PROs into the cancer rehabilitation setting to maximize efficiency.

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ACE-Neuro: A Tailored Exercise Oncology Program for Neuro-Oncology Patients – Study Protocol

10.1101/2021.09.08.21263307 ◽

2021 ◽

Author(s):

Julia T. Daun ◽

Lauren C. Capozzi ◽

Gloria Roldan Urgoiti ◽

Meghan H. McDonough ◽

Jacob C. Easaw ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Exercise Program ◽

Cancer Rehabilitation ◽

Secondary Outcome ◽

Functional Fitness ◽

Oncology Patients ◽

Primary Brain Tumours ◽

Primary Brain Tumour ◽

Patient Reported ◽

Exercise Oncology

AbstractBackgroundPatients with primary brain tumours lack access to exercise oncology and wellness resources. The purpose of the Alberta Cancer Exercise – Neuro-Oncology (ACE-Neuro) study is to assess the feasibility of a tailored neuro-oncology exercise program for patients across Alberta, Canada. The primary outcome is to assess the feasibility of ACE-Neuro. The secondary outcome is to examine preliminary effectiveness of ACE-Neuro on patient-reported outcomes and functional fitness.MethodsNeuro-oncology patients with a malignant or benign primary brain tumour that are pre, on, or completed treatment, are >18 years, and able to consent in English are eligible to participate in the study. Following referral from the clinical team to cancer rehabilitation and the study team, participants are triaged to determine their appropriateness for ACE-Neuro or other cancer rehabilitation or physiatry resources. In ACE-Neuro, participants complete a tailored 12-week exercise program with pre-post assessments of patient-reported outcomes, functional fitness, and physical activity. ACE-Neuro includes individual and group-based exercise sessions, as well as health coaching.ConclusionWe are supporting ACE-Neuro implementation into clinical cancer care, with assessment of needs enabling a tailored exercise prescription.

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Application and performance of Spanish language measures of the patient reported outcomes measurement information system (PROMIS) in a community-based yoga pilot study with overweight and obese Latina breast cancer survivors

Advances in Integrative Medicine ◽

10.1016/j.aimed.2018.02.015 ◽

2017 ◽

Vol 4 (3) ◽

pp. 127

Author(s):

Elizabeth Addington

Keyword(s):

Patient Reported Outcomes ◽

Breast Cancer Survivors ◽

Spanish Language ◽

Measurement Information ◽

Community Based ◽

Outcomes Measurement ◽

Patient Reported ◽

Measurement Information System ◽

Language Measures ◽

And Performance

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Predicting falls among patients with multiple sclerosis: Comparison of patient-reported outcomes and performance-based measures of lower extremity functions

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2017.06.014 ◽

2017 ◽

Vol 17 ◽

pp. 69-74 ◽

Cited By ~ 23

Author(s):

Shirin Tajali ◽

Mohammad-Jafar Shaterzadeh-Yazdi ◽

Hossein Negahban ◽

Jaap H. van Dieën ◽

Mohammad Mehravar ◽

...

Keyword(s):

Multiple Sclerosis ◽

Lower Extremity ◽

Patient Reported Outcomes ◽

Patient Reported ◽

And Performance

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Cancer rehabilitation outpatient consultation: Patient characteristics, symptom burden and quality of life.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.136 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 136-136

Author(s):

Carolina Gutierrez

Keyword(s):

Mental Health ◽

Standard Deviation ◽

Cancer Survivors ◽

Patient Reported Outcomes ◽

Cancer Rehabilitation ◽

Population Mean ◽

T Score ◽

Patient Reported ◽

The Us

136 Background: Cancer rehabilitation focuses on the functional and psychological needs of cancer survivors. Patient-reported outcomes have been increasingly used as part of the standard of care during clinical encounters. We review characteristics that patients present to their outpatient cancer rehabilitation consultation at a large academic hospital. Methods: Patients presenting for their first outpatient cancer rehabilitation consultation completed a paper copy of the PROMIS-10 (Patient Reported Outcomes Measurement Information System) instrument immediately prior to meeting with the physician. It includes 10 items evaluating quality of life, social life, functional activity, mental health, pain, and fatigue. A caregiver or health care provider could provide assistance in completing the form. Patient-reported outcomes were analyzed as part of an IRB-approved protocol. Data were analyzed using descriptive statistics and the “PROMIS Scoring Global Short Form v1.0 and v1.1” (12/16/2010). T-Score distributions are standardized such that a 50 represents the average (mean) for the US general population, and the standard deviation around that mean is 10 points. Results: Twenty-seven patients presented for consultation (63% women, 37% men) from 3/2014 through 6/2015 with an average age of 54.5 (44-76 range). Disease types included 52% brain tumors, 33% breast, 5% prostate, and 1% of each of the following: melanoma, myelofibrosis, and multiple myeloma. For our population, the physical health subscale score was 11.51 with a T-Score 38.6, standard error 4.1, a T-Score more than one standard deviation below the population mean. The mental health subscale was 11.92 with a T-Score 43.5, standard error 3.6, representing less than one standard deviation below the mean. The global health score was 28.55, which fell 2 standard deviations below the population mean. Conclusions: Compared to the US population mean, cancer survivors presenting for a cancer rehabilitation consultation had lower physical health than mental health. Our findings suggest the importance of screening cancer survivors for physical impairments and providing interventions focused on functional recovery.

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