Lifestyle coaching is feasible and improves pilot outcomes in fatigued brain tumour patients: the BT-LIFE (brain tumours, lifestyle interventions, and fatigue evaluation) multi-centre, phase II RCT
Rooney, A. G. Hewins, W. Walker, A. Withington, Lisa Mackinnon, M. Robson, Sara Green, Aimee Anderson, G. Bulbeck, H. Cochrane, C.
Rooney, A. G.
Hewins, W.
Walker, A.
Withington, Lisa
Mackinnon, M.
Robson, Sara
Green, Aimee
Anderson, G.
Bulbeck, H.
Cochrane, C.
Citations
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Abstract
BACKGROUND: Fatigue is common and disabling for brain tumour patients.
We studied the feasibility of two innovative lifestyle coaching interventions
for high fatigue. METHODS: Multi-centre phase II feasibility RCT
(ISRCTN17883425). Adult primary brain tumour outpatients reporting
significant fatigue (Brief Fatigue Inventory [BFI] score 4+), were randomised
to one of three arms: Control; Health Coaching (“HC”, comprising
eight structured coaching sessions on lifestyle behaviours); or HC plus Activation
Coaching (“HC+AC”, adding two structured interviews targeting
motivation to change). Outcomes were measured at baseline (T0), after
interventions (T1), and at 16 weeks (T2). The primary outcome of feasibility
was required for both recruitment (aim: average n= 5 fatigued patients
recruited/month) and retention (aim: minimum 60% retention at T2). Secondary
pilot outcomes included change in fatigue, depressive symptom, and
QOL measures. RESULTS: Over a nine-month recruitment period, n= 46
fatigued brain tumour patients were recruited (average n=5.1/month) and n=
34 were retained to endpoint (retention at T2= 73%), meeting the primary
outcome of feasibility. Surprisingly, fatigue reduced significantly after HC
(T1 mean change in BFI score from T0 baseline, relative to the equivalent
change in control group: HC= -2.3 points [95%CI -3.4/-0.3]; HC+AC= -2.0
[-2.9/+0.1]; ANOVA p= 0.02) and was reduced in magnitude in both intervention
groups at T2 (p= N.S). Both interventions also improved depressive
symptoms (T1 mean change in HADS-Depression: HC= -2.0 points [-5.6/-
0.1]; HC+AC= -2.9 [-6.5/-1.0]; Kruskal-Wallis p= 0.02). Patient-nominated
QOL outcomes improved persistently after HC+AC (T2 mean change in
PSYCHLOPS score: HC= -2.4 points [-5.4/+2.8]; HC+AC= -6.1 [-9.2/-0.8];
ANOVA p= 0.01). CONCLUSION: Innovative coaching interventions, focused
on lifestyle factors, are feasible to deliver to fatigued brain tumour
patients. Preliminary signals suggest that these non-drug approaches may
benefit several mediators of quality of life and warrant further study.
Affiliation
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Rooney AG, Hewins W, Walker A, Withington L, Mackinnon M, Robson S, et al. Innv-23. Lifestyle Coaching Is Feasible and Improves Pilot Outcomes in Fatigued Brain Tumour Patients: The Bt-Life (Brain Tumours, Lifestyle Interventions, and Fatigue Evaluation) Multi-Centre, Phase Ii Rct. Neuro-Oncology. 2020;22(Supplement_2):ii121-ii.