Psycho-Educational and Rehabilitative Intervention to Manage Cancer Cachexia (PRICC) for Advanced Patients and Their Caregivers: Lessons Learned from a Single-Arm Feasibility Trial

Cancers · 11 authors, 6 centres

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TL;DR

This single-arm feasibility trial tested a bimodal intervention (psycho-educational sessions and an exercise program) for advanced cancer patients with cachexia and their caregivers. The psycho-educational component was feasible for 83.3% of participants, but the exercise program was only feasible for 25.0%, with overall compliance greater than 50% achieved by only six dyads.

Full summary

635 CHARS

This prospective mixed-methods pilot study assessed the feasibility and acceptability of a psycho-educational and rehabilitative intervention for 24 dyads (advanced cancer patients with cachexia and their caregivers) at an Italian hospital. The intervention included psycho-educational sessions and an exercise program. The study did not meet its primary feasibility endpoint, with challenges including unpredictable disease progression and intervention demands. Findings highlight the acceptability of the approach but underscore the need for more robust studies to determine optimal exercise programs within multimodal cachexia care.

STUDY TYPE

other

SPECIALTY

oncology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10093308

Psycho-Educational and Rehabilitative Intervention to Manage Cancer Cachexia (PRICC) for Advanced Patients and Their Caregivers: Lessons Learned from a Single-Arm Feasibility Trial

Cancers

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ABSTRACT

Abstract Simple Summary Approximately half of all patients with advanced cancer experience cachexia, and the prevalence rises above 80% in the last weeks of life. Cancer cachexia (CC) is characterised by anorexia, systemic inflammation, ongoing loss of muscle mass, and weight loss, affecting the quality of life. Different treatments are proposed to manage CC, and comprehensive treatment requires a multidisciplinary approach aimed at evaluating overall patients’ conditions and relieving the symptoms, including psycho-social and spiritual functions. Key elements in CC management are personalized, multi-targeted, and multimodal interventions, but it is hard for some patients to follow programs based on several components. We examined the feasibility of a bimodal intervention, including a psycho-educational component and exercises, to support patients and their caregivers in managing CC. Our prospective mixed-methods pilot study explored feasibility data, changes in PROMS and performance outcomes over time, and qualitative data from dyads and healthcare professionals’ interviews. Abstract Background: Key elements in cancer cachexia (CC) management are personalized and multimodal interventions, but it is hard for some patients to follow programs based on several components. We examined the feasibility of a bimodal intervention, including a psycho-educational component and exercises, to support patients and their caregivers in managing CC; Methods: Prospective mixed-methods pilot study explored feasibility data, changes in patient-reported outcomes, and performance outcomes over time in a convenient sample of 30 consecutive CC patients and their caregivers. Results: Twenty-four dyads consented to participate. Twenty dyads received at least two psycho-educational sessions, so the psycho-educational component was feasible for 83.3% of the sample. Six dyads participated in at least fourteen out of twenty-seven rehabilitation sessions, so the exercise program was feasible for 25.0% of the sample. Six dyads showed compliance greater than 50% for both components of the bimodal intervention. Conclusions: While we did not meet our primary feasibility endpoint and had mixed acceptability, our experience provides insight into the challenges and lessons learned in implementing a primary palliative care intervention for CC. More robust studies are needed to help clinicians understand the best exercise program for CC patients, to be included in a multimodal intervention. Keywords: cancer cachexia, exercise, cancer rehabilitation, palliative medicine, non-pharmacologic treatment, psycho-educational treatment, psycho-social treatment

CITATION EXPORT

Loredana Buonaccorso, Stefania Fugazzaro, Cristina Autelitano et al.. Psycho-Educational and Rehabilitative Intervention to Manage Cancer Cachexia (PRICC) for Advanced Patients and Their Caregivers: Lessons Learned from a Single-Arm Feasibility Trial. Cancers. (2023). https://doi.org/10.3390/cancers15072063

AUTHORS

11 · 6 CENTRES

Loredana Buonaccorso, Stefania Fugazzaro, Cristina Autelitano, Elisabetta Bertocchi, Monia Allisen Accogli, Monica Denti, Stefania Costi, Gianfranco Martucci, Luca Braglia, Maria Chiara Bassi, Silvia Tanzi

1Scientific Directorate, Azienda USL-IRCSS di Reggio Emilia, 42122 Reggio Emilia, Italy
2Physical Medicine and Rehabilitation Unit, Azienda USL-IRCSS di Reggio Emilia, 42122 Reggio Emilia, Italy
3Palliative Care Unit, Azienda USL-IRCSS di Reggio Emilia, 42122 Reggio Emilia, Italy
4Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Via del Pozzo No. 74, 41100 Modena, Italy
5Local Network of Palliative Care, AUSL Modena, 41100 Modena, Italy
6Medical Library, Azienda USL-IRCSS di Reggio Emilia, 42122 Reggio Emilia, Italy